Active NPI
Ryan J Smilanich, DPT
- Physical Therapist
- Oak Creek, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 16103
- Practice address
- 200 E Ryan Rd
Oak Creek, WI 53154-4563 - Phone
- (414) 570-3590
- Fax
- (414) 570-3599
- NPI assigned
- Sep 14, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | |||
| Physical Therapist | 225100000X | 16103 | WI | Primary |
Addresses
Primary practice location
200 E Ryan Rd
Oak Creek, WI 53154-4563
Mailing address
PO Box 735044
Chicago, IL 60673-5044
Phone (414) 570-3590
Other practice location 1
8020 S Howell Ave
Oak Creek, WI 53154-2930
Phone (414) 647-3920
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100224116 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rsmilanich316696@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
200 E Ryan Rd
Oak Creek, WI 53154-4563
Phone (414) 570-3590
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16103 | WI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ascension Medical Group-Southeast Wisconsin Inc | Current | Accepting new patients | |
| Lakeshore Medical Clinic LTD | Current | Accepting new patients | |
| Lakeshore Medical Clinic, LLC | Physical Therapist | Current | Accepting new patients |
Locations
13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400
S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747
200 E Ryan Rd
Oak Creek, WI 53154
Phone (414) 570-3590
8020 S Howell Ave
Oak Creek, WI 53154
Phone (414) 647-3920
2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880
201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228
Interoperability endpoints
- rsmilanich316696@direct.myadvocateaurora.org
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Saint Francis, WI
- NPI 1003861188
Physical Therapist
-
- Internal Medicine Physician
- Glendale, WI
- NPI 1609881077
-
- Family Medicine Physician
- South Milwaukee, WI
- NPI 1174851893
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683676800000",
"number": "1811619075",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 735044",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606735044",
"telephone_number": "414-570-3590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 E RYAN RD",
"city": "OAK CREEK",
"state": "WI",
"postal_code": "531544563",
"telephone_number": "414-570-3590",
"fax_number": "414-570-3599"
}
],
"practiceLocations": [
{
"address_1": "8020 S Howell Ave",
"address_purpose": "LOCATION",
"city": "Oak Creek",
"state": "WI",
"postal_code": "531542930",
"country_code": "US",
"telephone_number": "414-647-3920",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SMILANICH",
"first_name": "RYAN",
"middle_name": "J",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-09-14",
"last_updated": "2023-05-10",
"certification_date": "2023-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "16103",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100224116",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rsmilanich316696@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "200 E Ryan Rd",
"city": "Oak Creek",
"state": "WI",
"country_code": "US",
"postal_code": "531544563",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "200 E Ryan Rd",
"city": "Oak Creek",
"state": "WI",
"country_code": "US",
"postal_code": "531544563",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Oak Creek, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2023; 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.