Mr Anthony Jack Ettmayer Jr, PT in Port Washington, WI - Medicare Physical Therapist Provider

Mr Anthony Jack Ettmayer Jr, PT is a medicare enrolled "Physical Therapist" provider in Port Washington, Wisconsin. His current practice location is 1119 N Wisconsin St, Port Washington, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (262) 284-5892.

Mr Anthony Jack Ettmayer Jr is licensed to practice in Wisconsin (license number 11821-024) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1457649352.

Contact Information

	Mr Anthony Jack Ettmayer Jr, PT
	1119 N Wisconsin St, Port Washington, WI 53074-1209
	(262) 284-5892
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mr Anthony Jack Ettmayer Jr
Gender	Male
Speciality	Physical Therapist
Location	1119 N Wisconsin St, Port Washington, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1457649352
Provider Enumeration Date: 07/13/2011
Last Update Date: 07/13/2011

Medicare PECOS Information:

PECOS PAC ID: 5597019323
Enrollment ID: I20181114002785

Medical Identifiers

Medical identifiers for Mr Anthony Jack Ettmayer Jr such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1457649352	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	11821-024 (Wisconsin)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Anthony Jack Ettmayer Jr allows following entities to bill medicare on his behalf.

Provider Name	Great Lakes Healthcare Inc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1184282618 PECOS PAC ID: 5395079719 Enrollment ID: O20190730000104

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Anthony Jack Ettmayer Jr is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Anthony Jack Ettmayer Jr, PT 1119 N Wisconsin St, Port Washington, WI 53074-1209 Ph: (262) 284-5892	Mr Anthony Jack Ettmayer Jr, PT 1119 N Wisconsin St, Port Washington, WI 53074-1209 Ph: (262) 284-5892

Reviews and Comments

Physical Therapist in Port Washington, WI

Sheri L Bunyan, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1119 N Wisconsin St, Port Washington, WI 53074 Phone: 262-284-5892
Brianna Rae Zimmerman, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1119 N Wisconsin St, Port Washington, WI 53074 Phone: 262-284-5892
Maja Kern, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1475 W Grand Ave, Port Washington, WI 53074 Phone: 262-268-5100
David Arthur Peterson, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1317 W Grand Ave, Port Washington, WI 53074 Phone: 262-284-2261
Breanne N Beres, DPT, ATC Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1475 W Grand Ave, Port Washington, WI 53074 Phone: 262-268-5100
Mrs. Kimberly Burns Klug, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1317 W Grand Ave, Lake Hills Medical Complex, Port Washington, WI 53074 Phone: 262-284-2261

Mr Anthony Jack Ettmayer Jr, PT - Medicare Physical Therapist in Port Washington, WI