Individual provider Active NPI

Elizabeth Jane Muellenbach, P.T.

  • Physical Therapist
  • Slinger, WI
National Provider Identifier
1841409497
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5661 Issued in WI
Practice address
1048 E Commerce Blvd
Slinger, WI 53086-9326
Phone
(262) 644-6268
NPI assigned
May 21, 2007
Last updated
Dec 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 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 5661 WI Primary

Addresses

Primary practice location

1048 E Commerce Blvd
Slinger, WI 53086-9326

Mailing address

3972 Elaines Way
Slinger, WI 53086-9631
Phone (262) 644-4512

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address emuellenbach13740@direct.myadvocateaurora.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060105000802 WI Practitioner - Physical Therapist in Private Practice 0042233926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians

Practice addresses (Care Compare)

N112 W17975 Mequon Rd
Germantown, WI 53022-2425
Phone (262) 532-7600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Advanced Healthcare, Inc. CurrentSince Nov 10, 2020 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Nov 10, 2020 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

N112W17975 Mequon Rd
Germantown, WI 53022
Phone (262) 532-7600

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

N168W20060 Main St
Jackson, WI 53037
Phone (262) 677-3003

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

Interoperability endpoints

  • Direct secure messaging: emuellenbach13740@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, 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": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1841409497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3972 ELAINES WAY",
            "city": "SLINGER",
            "state": "WI",
            "postal_code": "530869631",
            "telephone_number": "262-644-4512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1048 E COMMERCE BLVD",
            "city": "SLINGER",
            "state": "WI",
            "postal_code": "530869326",
            "telephone_number": "262-644-6268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUELLENBACH",
        "first_name": "ELIZABETH",
        "middle_name": "JANE",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "5661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1048 E Commerce Blvd",
            "city": "Slinger",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530869326",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "emuellenbach13740@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "1048 E Commerce Blvd",
            "city": "Slinger",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530869326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Slinger, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 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.