Fastback Physical Therapy LLC
NPI 1104393982ActiveOrganization· Physical Therapist· New Berlin, WI
Physical Therapist in New Berlin, Wisconsin, registered in NPPES in October 2018. The authorized official on file is Michele Weninger, Credentialing Specialist. Enrolled in Medicare as part b supplier - physical/occupational therapy group in private practice.
Overview
| NPI | 1104393982 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 30, 2018 |
| Last updated in NPPES | Aug 6, 2024 |
| Certified by provider | Aug 6, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
| Counselor, Mental Health | 101YM0800X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Physical/Occupational Therapy Group in Private Practice (WI) |
|---|
Other physical therapists in New Berlin
- 1013691732
- 1023771219
- 1043575616
- 1184351553
- 1255436572
- 1306640602
- 1326071200
- 1336607100
- 1417257015
- 1457775314
- 1639226756
- 1659436368
All 83 physical therapists in New Berlin · All physical therapists in Wisconsin