Jennifer B Alizadeh, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12075-24 Issued in WI

Practice address

597 Kingswood Ave
Fond Du Lac, WI 54935-6399

Phone

(920) 238-3032

Fax

(920) 238-3048

NPI assigned

Jun 13, 2012

Last updated

Oct 12, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Froedtert Andthe Medical College of Wisconsin Community Physicians IncGroup PAC ID 3678760063, 1,265 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Internal Medicine Physician
  • Menomonee Falls, WI
  • NPI 1568787448
  Medicare reassignment Care Compare group NPD
• Sundance Rehabilitation LLC

  • Rehabilitation Clinic/Center
  • Deforest, WI
  • NPI 1073912119

  Physical Therapist

  Medicare reassignment NPD
• Athletic & Therapeutic Institute of Milwaukee, LLC

  dba ATI Physical Therapy

  • Physical Therapist
  • Pewaukee, WI
  • NPI 1801907464
  Medicare reassignment
• Athletic and Therapeutic Institute of Milwaukee, LLC

  dba ATI Active Care

  • Nurse Practitioner
  • Pewaukee, WI
  • NPI 1538581418
  NPD
• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Wauwatosa, WI
  • NPI 1154947224
  NPD
• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086

  Physical Therapist

  NPD

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

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476230400000",
    "number": "1942562152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 ELM GROVE RD",
            "address_2": "APT 4",
            "city": "ELM GROVE",
            "state": "WI",
            "postal_code": "531222545",
            "telephone_number": "262-492-9080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "597 KINGSWOOD AVE",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549356399",
            "telephone_number": "920-238-3032",
            "fax_number": "920-238-3048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALIZADEH",
        "first_name": "JENNIFER",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-13",
        "last_updated": "2016-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "12075-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Agnesian Healthcare, Inc (SSM Health at Home Home Health Fond Du Lac)
• Agnesian Healthcare, Inc (St Agnes Hospital Hospice Hope)
• Kabir Ahmed, M.D.
• Jennifer Ajide
• Alicia Hans LCSW
• Reem Aljamaan, BDS, DDS, CAGS, MSD
• Allay Home and Hospice, Inc. (Generations Hospice)
• Desirae Nichole Alsum
• Anchor Point Home Health Services
• Anderson Chiropractic Office LLC

• Physical Therapist in Fond Du Lac, WI
• Providers in Fond Du Lac, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.