Individual provider Active NPI

Andrew Telschow, DPT

  • Physical Therapist
  • Hales Corners, WI
National Provider Identifier
1972242238
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
15819-24 Issued in WI
Practice address
5764 S 108TH St
Hales Corners, WI 53130-1947
Phone
(414) 400-7110
Fax
(414) 400-7112
NPI assigned
Jun 3, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 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 15819-24 WI Primary

Addresses

Primary practice location

5764 S 108TH St
Hales Corners, WI 53130-1947

Mailing address

5764 S 108TH St
Hales Corners, WI 53130-1947
Phone (414) 400-7110

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220805000568 WI Practitioner - Physical Therapist in Private Practice 4688056724 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aretas02 LLCGroup PAC ID 3870951882, 5 clinicians

Practice addresses (Care Compare)

5764 S 108TH St
Hales Corners, WI 53130-1947
Phone (414) 400-7110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15819-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Team Rehabilitation Services, LLC Physical Therapist CurrentSince Jun 2, 2022 Accepting new patients
Aretas02, LLC Physical Therapist CurrentSince May 27, 2023 Accepting new patients
Team Rehabilitation Services, LLC Physical Therapist CurrentSince Jun 2, 2022 Accepting new patients

Locations

33900 Harper Ave
Ste 104
Clinton Twp, MI 48035
Phone (586) 416-9100

5764 S 108th St
Hales Corners, WI 53130
Phone (414) 400-7110

11363 N Port Washington Rd
Mequon, WI 53092
Phone (262) 833-2060

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1654214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1972242238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5764 S 108TH ST",
            "city": "HALES CORNERS",
            "state": "WI",
            "postal_code": "531301947",
            "telephone_number": "414-400-7110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5764 S 108TH ST",
            "city": "HALES CORNERS",
            "state": "WI",
            "postal_code": "531301947",
            "telephone_number": "414-400-7110",
            "fax_number": "414-400-7112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELSCHOW",
        "first_name": "ANDREW",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-03",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "15819-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hales Corners, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.