Active NPI
Jose David Delgadillo
- Physical Therapy Assistant
- Milwaukee, WI
National Provider Identifier
1912696931
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 4063-19
- Practice address
- 10101 W Wisconsin Ave
Milwaukee, WI 53226-4861 - Phone
- (414) 259-6310
- NPI assigned
- May 4, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 4063-19 | WI | Primary |
Addresses
Primary practice location
10101 W Wisconsin Ave
Milwaukee, WI 53226-4861
Mailing address
9075 W Sura LN Unit 119
Greenfield, WI 53228-3525
Phone (414) 238-5125
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4063-19 | WI | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683158400000",
"number": "1912696931",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9075 W SURA LN UNIT 119",
"city": "GREENFIELD",
"state": "WI",
"postal_code": "532283525",
"telephone_number": "414-238-5125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10101 W WISCONSIN AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532264861",
"telephone_number": "414-259-6310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELGADILLO",
"first_name": "JOSE",
"middle_name": "DAVID",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-05-04",
"last_updated": "2023-05-04",
"certification_date": "2023-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WI",
"license": "4063-19",
"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 May 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.