Individual provider Active NPI

Daniel A. Pauley, PT, OCS

  • Orthopedic Physical Therapist
  • Glendale, WI
National Provider Identifier
1790974673
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
2060 Issued in WI
Practice address
5150 N Port Washington Rd Ste 130
Glendale, WI 53217-5470
Phone
(414) 332-0707
Fax
(414) 332-3670
NPI assigned
Oct 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 2060 WI Primary

Addresses

Primary practice location

5150 N Port Washington Rd Ste 130
Glendale, WI 53217-5470

Mailing address

5150 N Port Washington Rd Ste 130
Glendale, WI 53217-5470
Phone (414) 332-0707

Other identifiers 2

IdentifierTypeStateIssuer
391605943011OtherWIBCBS GROUP
40169700MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wisconsin Orthopedic Rehabilitation Consultants, Inc. Orthopedic Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192579200000",
    "number": "1790974673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 N PORT WASHINGTON RD STE 130",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532175470",
            "telephone_number": "414-332-0707",
            "fax_number": "414-332-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 N PORT WASHINGTON RD STE 130",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532175470",
            "telephone_number": "414-332-0707",
            "fax_number": "414-332-3670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULEY",
        "first_name": "DANIEL",
        "middle_name": "A.",
        "credential": "PT, OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-17",
        "last_updated": "2007-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "WI",
            "license": "2060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "391605943011",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40169700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.