Jack Heinrich, PT, DPT, CSCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

16297-24 Issued in WI

Practice address

10930 W Potter Rd Ste C
Wauwatosa, WI 53226-3450

Phone

(414) 400-6556

Fax

(414) 400-6557

NPI assigned

Jun 8, 2023

Last updated

Jun 8, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Wisconsin School of Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aretas01 LLCGroup PAC ID 0244699460, 5 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.

• Aretas01, LLC

  • Physical Therapist
  • Wauwatosa, WI
  • NPI 1801583224
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1686182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1942994256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10930 W POTTER RD STE C",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532263450",
            "telephone_number": "414-400-6556",
            "fax_number": "414-400-6557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10930 W POTTER RD STE C",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532263450",
            "telephone_number": "414-400-6556",
            "fax_number": "414-400-6557"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5764 S 108th St",
            "address_purpose": "LOCATION",
            "city": "Hales Corners",
            "state": "WI",
            "postal_code": "531301947",
            "country_code": "US",
            "telephone_number": "414-400-7110",
            "fax_number": "414-400-7112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEINRICH",
        "first_name": "JACK",
        "credential": "PT, DPT, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-08",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "16297-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Health Network of Wisconsin
• Heart Emergency Physicians, LLP
• Mindyn A Heimsch, PA
• Gayle M Heinrich, D.D.S.
• Geoffrey W Heinrich, D.D.S.
• Alice M. Held, NP
• Jessica Leigh Heller, DC
• Anne Therese Helmer, NNP-BC, APNP
• Mary May Henderson, NURSE PRACTITIONER
• Amanda M Henke, DPT

• Physical Therapist in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; 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.