Active NPI
Kevin Jon Brusse, P.T.
- Physical Therapist
- Sheboygan, WI
National Provider Identifier
1992929582
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 9888-024
- Practice address
- 2629 N 7TH St
Sheboygan, WI 53083-4932 - Phone
- (920) 451-5000
- NPI assigned
- Apr 13, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 9888 | WI | |
| Sports Physical Therapist | 2251S0007X | 9888 | WI | |
| Physical Therapist | 225100000X | 9888-024 | WI | Primary |
Addresses
Primary practice location
2629 N 7TH St
Sheboygan, WI 53083-4932
Mailing address
1099 Creeks Cross CT
Kohler, WI 53044-1347
Phone (920) 208-8670
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40471600 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ | ||
| Direct Messaging Address | kbrusse86468@direct.myadvocateaurora.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3400 Union Ave
Sheboygan, WI 53081-8426
Phone (920) 828-2530
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9888-024 | WI | MD | Physical Therapist |
| 9888 | WI | MD | Orthopedic Physical Therapist |
| 5496 | SC | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Medical Group, Inc. | Past | Accepting new patients | |
| Aurora Health Care Central, Inc. | Past | Accepting new patients | |
| Carolina Sportscare and Physical Therapy | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Certified Registered Nurse Anesthetist
- Milwaukee, WI
- NPI 1427271378
-
- General Acute Care Hospital
- Sheboygan, WI
- NPI 1922053107
-
- Durable Medical Equipment & Medical Supplies
- Manitowoc, WI
- NPI 1801941075
-
- Physical Therapist
- Beaufort, SC
- NPI 1659306785
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638921600000",
"number": "1992929582",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1099 CREEKS CROSS CT",
"city": "KOHLER",
"state": "WI",
"postal_code": "530441347",
"telephone_number": "920-208-8670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2629 N 7TH ST",
"city": "SHEBOYGAN",
"state": "WI",
"postal_code": "530834932",
"telephone_number": "920-451-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUSSE",
"first_name": "KEVIN",
"middle_name": "JON",
"name_prefix": "Mr.",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-13",
"last_updated": "2021-12-08",
"certification_date": "2021-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "WI",
"license": "9888",
"primary": false
},
{
"code": "2251S0007X",
"taxonomy_group": "",
"desc": "Physical Therapist, Sports",
"state": "WI",
"license": "9888",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "9888-024",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40471600",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "2629 N 7th St",
"city": "Sheboygan",
"state": "WI",
"country_code": "US",
"postal_code": "530834932",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kbrusse86468@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2629 N 7th St",
"city": "Sheboygan",
"state": "WI",
"country_code": "US",
"postal_code": "530834932",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Sheboygan, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.