Tyler William Wendt, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

16791-24 Issued in WI

Practice address

102 W Fulton St
Edgerton, WI 53534-1839

Phone

(608) 561-7733

NPI assigned

Jun 4, 2024

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

Mayo Medical School, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Forward Physical Therapy LLC 6 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 and National Provider Directory roles.

• Forward Physical Therapy LLC

  • Physical Therapist
  • Edgerton, WI
  • NPI 1942774252
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1717459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1992546840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3936 GEORGE RD",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544959371",
            "telephone_number": "715-459-7184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W FULTON ST",
            "city": "EDGERTON",
            "state": "WI",
            "postal_code": "535341839",
            "telephone_number": "608-561-7733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENDT",
        "first_name": "TYLER",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "16791-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tonya Jo Vike, RN
• Daphne Wang, SPEECH PATHOLOGIST
• Nasra Mohamed Warsame, M.D.
• Jedd P Wellenkotter, DPT
• Kristen Wellenkotter, DPT
• Lance Edward Wiese, RPH
• Wil Hospitalists LLC
• Kyle John Wille, D.C.
• Wisconsin Illinois Senior Housing Inc.
• Wisconsin Illinois Senior Housing, Inc.

• All providers in Edgerton, WI
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.