Individual provider Active NPI

Mackenzie Vanden Heuvel, PT, DPT

  • Physical Therapist
  • Manitowoc, WI
National Provider Identifier
1932931243
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
16933-24 Issued in WI
Practice address
1650 S 41St St
Manitowoc, WI 54220-7316
Phone
(920) 320-3100
Fax
(920) 320-5114
NPI assigned
Aug 15, 2024
Last updated
Aug 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 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 16933-24 WI Primary

Addresses

Primary practice location

1650 S 41St St
Manitowoc, WI 54220-7316

Mailing address

1650 S 41St St
Manitowoc, WI 54220-7316
Phone (920) 320-3100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260113003276 WI Practitioner - Physical Therapist in Private Practice 6507342151 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Creighton University School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

W168N11237 Western Ave
Germantown, WI 53022-3239
Phone (262) 253-5060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16933-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Dec 29, 2025 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Dec 29, 2025 Accepting new patients
The Medical College of Wisconsin, Inc. Physical Therapist Current Accepting new patients

Locations

1350 S Sunny Slope Rd
Brookfield, WI 53005
Phone (262) 798-8750

21700 Intertech Dr
Brookfield, WI 53045
Phone (262) 532-8300

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

110 Lone Oak Ln
Hartford, WI 53027
Phone (262) 670-1800

W225N16711 Cedar Park Ct
Jackson, WI 53037
Phone (262) 618-2228

1701 Fond du Lac Ave
Kewaskum, WI 53040
Phone (262) 626-4616

1650 S 41st St
Manitowoc, WI 54220
Phone (920) 320-3100

N91W15750 Falls Pkwy
Menomonee Falls, WI 53051
Phone (262) 532-1100

W129N7055 Northfield Dr
Menomonee Falls, WI 53051
Phone (262) 251-5305

11430 N Port Washington Rd
Mequon, WI 53092
Phone (262) 518-1900

1271 N 6th St
Milwaukee, WI 53212
Phone (414) 978-9037

4805 S Moorland Rd
New Berlin, WI 53151
Phone (262) 798-7200

2315 E Moreland Blvd
Waukesha, WI 53186
Phone (262) 532-5700

W234S3555 State Road 59
Waukesha, WI 53189
Phone (262) 349-9297

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

1700 W Paradise Dr
West Bend, WI 53095
Phone (262) 334-3451

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1723680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1932931243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 S 41ST ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542207316",
            "telephone_number": "920-320-3100",
            "fax_number": "920-320-5114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 S 41ST ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542207316",
            "telephone_number": "920-320-3100",
            "fax_number": "920-320-5114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDEN HEUVEL",
        "first_name": "MACKENZIE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-15",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "16933-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manitowoc, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.