NPIMap

Organization Active NPI

NX Level Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Waukesha, WI
National Provider Identifier
1972864155
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
10389-24 Issued in WI
Legal business name
NX LEVEL PHYSICAL THERAPY LLC
Practice address
W229N1416 Westwood Dr Ste 4
Waukesha, WI 53186-1309
Phone
(262) 349-9297
Fax
(262) 278-4062
NPI assigned
Jun 4, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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

Authorized official

Name
Matthew Gibbons, PTNPI 1659352938
Title
Owner
Phone
(262) 349-9297

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 10389-24 WI Primary

Addresses

Primary practice location

W229N1416 Westwood Dr Ste 4
Waukesha, WI 53186-1309

Mailing address

W229N1416 Westwood Dr Ste 4
Waukesha, WI 53186-1309
Phone (262) 349-9297

Other names 1

  • Fyzical Therapy and Balance Waukesha Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180711002162 WI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4385990092 Receives reassigned benefits from 3 practitioners
Practice locations: Waukesha, WI

National Provider Directory

National Provider Directory

Locations

W229N1416 Westwood Dr
Ste 4
Waukesha, WI 53186
Phone (262) 349-9297

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

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1338768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616630400000",
    "number": "1972864155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W229N1416 WESTWOOD DR STE 4",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531861309",
            "telephone_number": "262-349-9297",
            "fax_number": "262-278-4062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W229N1416 WESTWOOD DR STE 4",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531861309",
            "telephone_number": "262-349-9297",
            "fax_number": "262-278-4062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NX LEVEL PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-04",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A",
        "authorized_official_last_name": "GIBBONS",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-349-9297",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "WI",
            "license": "10389-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fyzical Therapy and Balance Waukesha",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.