Individual provider Active NPI

Megan M Moore, PT, DPT

  • Physical Therapist
  • Beaver Dam, WI
National Provider Identifier
1851999114
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
15259-24 Issued in WI
Practice address
707 S University Ave
Beaver Dam, WI 53916-3027
Phone
(920) 887-7181
NPI assigned
Oct 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2024

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 15259-24 WI Primary

Addresses

Primary practice location

707 S University Ave
Beaver Dam, WI 53916-3027

Mailing address

707 S University Ave
Beaver Dam, WI 53916-3027
Phone (920) 887-7181

Other practice location 1

459 E 1st St
Fond Du Lac, WI 54935-4505
Phone (920) 929-3500

Other practice location 2

1508 S Church St
Watertown, WI 53094-6404
Phone (800) 974-4378 ext. 1948

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230929000111 WI Practitioner - Physical Therapist in Private Practice 7810341518 Reassigns benefits to 10 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DPT Holdings LLCGroup PAC ID 4688679293, 170 clinicians

Practice addresses (Care Compare)

1508 S Church St
Watertown, WI 53094-6404
Phone (800) 974-4378

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Flambeau Hospital Inc CurrentSince Aug 16, 2023 Accepting new patients
Memorial Hospital Inc CurrentSince Aug 16, 2023 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
MCHS Hospitals Inc CurrentSince Aug 16, 2023 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Aug 16, 2023 Accepting new patients
MCHS Hospitals Inc CurrentSince Aug 16, 2023 Accepting new patients
Marshfield Clinic Inc CurrentSince Aug 16, 2023 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Aug 16, 2023 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Aug 16, 2023 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Aug 16, 2023 Accepting new patients
DPT Holdings PLLC Physical Therapist CurrentSince Apr 4, 2024 Accepting new patients
Flambeau Hospital Inc Current Accepting new patients

Locations

707 S University Ave
Beaver Dam, WI 53916
Phone (920) 887-4006

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

3825 39th Ave
Ste 110
Kenosha, WI 53144
Phone (262) 605-6810

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

1508 S Church St
Watertown, WI 53094
Phone 8009744378 ext. 1948

Interoperability endpoints

  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1602201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1851999114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 S UNIVERSITY AVE",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539163027",
            "telephone_number": "920-887-7181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 S UNIVERSITY AVE",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539163027",
            "telephone_number": "920-887-7181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "459 E 1st St",
            "address_purpose": "LOCATION",
            "city": "Fond Du Lac",
            "state": "WI",
            "postal_code": "549354505",
            "country_code": "US",
            "telephone_number": "920-929-3500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1508 S Church St",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "WI",
            "postal_code": "530946404",
            "country_code": "US",
            "telephone_number": "800-974-4378 x1948",
            "fax_number": "630-515-1536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MEGAN",
        "middle_name": "M",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-09",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "15259-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "707 S University Ave",
            "city": "Beaver Dam",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539163027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Beaver Dam, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; 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.