Individual provider Active NPI

Brianne M Jeras, MPT

  • Physical Therapist
  • Menomonee Falls, WI
National Provider Identifier
1801981782
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10559-024 Issued in WI
Practice address
N81W15014 Appleton Ave
Menomonee Falls, WI 53051-3839
Phone
(262) 714-7040
Fax
(262) 714-7041
NPI assigned
Oct 4, 2006
Last updated
Apr 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 10559-024 WI Primary

Addresses

Primary practice location

N81W15014 Appleton Ave
Menomonee Falls, WI 53051-3839

Mailing address

33900 Harper Ave Ste 104
Clinton TWP, MI 48035-4258
Phone (586) 350-2644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061201000290 WI Practitioner - Physical Therapist in Private Practice 2860490729 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sport Clinic Physical Therapy IncGroup PAC ID 0244285187, 8 clinicians

Practice addresses (Care Compare)

10620 N Port Washington Rd
Suite 202
Mequon, WI 53092-5048
Phone (414) 351-5794

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10559-024WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Body Renovation Health Services, S.C. PastSince Nov 20, 2021 Accepting new patients
Elite Sport & Spine, LLC Physical Therapist PastSince Nov 2, 2013 Accepting new patients
Wisconsin Orthopedic Rehabilitation Consultants, Inc. Physical Therapist Past Accepting new patients

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1801981782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33900 HARPER AVE STE 104",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480354258",
            "telephone_number": "586-350-2644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N81W15014 APPLETON AVE",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530513839",
            "telephone_number": "262-714-7040",
            "fax_number": "262-714-7041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERAS",
        "first_name": "BRIANNE",
        "middle_name": "M",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "10559-024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menomonee Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.