Stefanie Acevedo-Thomas, PTA

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

16841-24 Issued in WI

Practice address

2999 N Mayfair Rd Ste 300
Wauwatosa, WI 53222-4306

Phone

(414) 479-3737

NPI assigned

Jun 2, 2020

Last updated

Aug 27, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Stefanie Acevedo Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1591056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1851915102",
    "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": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2999 N MAYFAIR RD STE 300",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532224306",
            "telephone_number": "414-479-3737"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5764 S 108th St",
            "address_purpose": "LOCATION",
            "city": "Hales Corners",
            "state": "WI",
            "postal_code": "531301947",
            "country_code": "US",
            "telephone_number": "414-488-0330",
            "fax_number": "414-488-0331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ACEVEDO-THOMAS",
        "first_name": "STEFANIE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-02",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "16841-24",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100281964",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sacevedothomas64101@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2999 N Mayfair Rd Ste 300",
            "city": "Wauwatosa",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532224306",
            "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": "2999 N Mayfair Rd Ste 300",
            "city": "Wauwatosa",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532224306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "STEFANIE",
            "last_name": "ACEVEDO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapist in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; 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.