Individual provider Active NPI

Gregory Mishica

  • Physical Therapist
  • Escanaba, MI
National Provider Identifier
1922545250
Registry record updated Jan 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
54502009968 Issued in MI
Practice address
3401 Ludington St
Escanaba, MI 49829-1300
Phone
(906) 428-5406
NPI assigned
Jan 25, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2017

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 54502009968 MI Primary

Addresses

Primary practice location

3401 Ludington St
Escanaba, MI 49829-1300

Mailing address

3401 Ludington St
Escanaba, MI 49829-1300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211115002543 WI Practitioner - Physical Therapist in Private Practice 0547659435 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Washington University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopedic and Spine Therapy of Menasha SCGroup PAC ID 8123923869, 20 clinicians

Practice addresses (Care Compare)

4000 N Providence Ave
Appleton, WI 54913-8018
Phone (920) 968-0814

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
54502009968MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Services Wi LLC Physical Therapist CurrentSince Jun 1, 2023 Accepting new patients
Orthopedic & Spine Therapy of Lakewood, SC Physical Therapist CurrentSince Feb 12, 2024 Accepting new patients
Orthopedic & Spine Therapy of Green Bay, SC Physical Therapist CurrentSince Oct 25, 2021 Accepting new patients
Orthopedic and Spine Therapy of Menasha SC Physical Therapist CurrentSince Oct 25, 2021 Accepting new patients
Orthopedic & Spine Therapy of Menasha SC Physical Therapist CurrentSince Oct 25, 2021 Accepting new patients
Orthopedic & Spine Therapy of Green Bay SC Physical Therapist CurrentSince Oct 25, 2021 Accepting new patients
Orthopedic & Spine Therapy of Brillion, SC Physical Therapist Current Accepting new patients
Orthopedic & Spine Therapy of Physical Therapist CurrentSince Feb 12, 2024 Accepting new patients
Orthopedic & Spine Therapy of Menasha SC Physical Therapist Past Accepting new patients

Locations

4000 N Providence Ave
Appleton, WI 54913
Phone (920) 257-2000

544 Fairway Dr
Brillion, WI 54110
Phone (920) 756-9340

3108 Mid Valley Dr
De Pere, WI 54115
Phone (920) 432-9040

301 N Broadway
Ste 206
De Pere, WI 54115
Phone (920) 257-2000

1 Bank Ave
Ste C
Kaukauna, WI 54130
Phone (920) 759-9075

1000 Midway Rd
Menasha, WI 54952
Phone (920) 257-2000

Organizations & group practices 9

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": "1485302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485302400000",
    "number": "1922545250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 LUDINGTON ST",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "498291300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 LUDINGTON ST",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "498291300",
            "telephone_number": "906-428-5406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISHICA",
        "first_name": "GREGORY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-25",
        "last_updated": "2017-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "54502009968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Escanaba, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2017; 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.