Individual provider Active NPI

Kurt Vercimak, D.P.T.

  • Physical Therapist
  • Milwaukee, WI
National Provider Identifier
1881885853
Registry record updated Dec 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10858-024 Issued in WI
Practice address
1575 N Rivercenter Dr
Milwaukee, WI 53212-3978
Phone
(414) 224-6424
NPI assigned
Aug 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2016

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 10858-024 WI Primary

Addresses

Primary practice location

1575 N Rivercenter Dr
Milwaukee, WI 53212-3978

Mailing address

1575 N Rivercenter Dr
Milwaukee, WI 53212-3978
Phone (414) 224-6424

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070828000670 WI Practitioner - Physical Therapist in Private Practice 3072605591 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Orthopedic Specialty Hospital, LLCGroup PAC ID 7113078833, 65 clinicians

Practice addresses (Care Compare)

3033 W Layton Ave
Suite 202
Milwaukee, WI 53221-2637
Phone (414) 567-3022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10858-024WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Orthopedic Specialty Hospital, LLC CurrentSince May 10, 2023 Accepting new patients
Midwest Orthopedic Specialty Hospital, LLC CurrentSince May 10, 2023 Accepting new patients
Sport Clinic of Greater Milwaukee Physical Therapist PastSince Jul 31, 2017 Accepting new patients

Locations

7095 S Ballpark Dr
Unit 100
Franklin, WI 53132
Phone (414) 817-6620

5700 S 108th St
Hales Corners, WI 53130
Phone (414) 239-9448

3033 W Layton Ave
Ste 202
Milwaukee, WI 53221
Phone (414) 567-3022

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.

NPI Registry JSON

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482278400000",
    "number": "1881885853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 N RIVERCENTER DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532123978",
            "telephone_number": "414-224-6424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 N RIVERCENTER DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532123978",
            "telephone_number": "414-224-6424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERCIMAK",
        "first_name": "KURT",
        "name_prefix": "Mr.",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-06",
        "last_updated": "2016-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "10858-024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2016; 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.