Karisa Nicole Gloudemans, DPT in Wautoma, WI - Medicare Physical Therapist Provider

Karisa Nicole Gloudemans, DPT is a medicare enrolled "Physical Therapist" provider in Wautoma, Wisconsin. Her current practice location is N2930 State Road 22, Wautoma, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (920) 787-5030.

Karisa Nicole Gloudemans is licensed to practice in Wisconsin (license number 16514-24) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1740963057.

Contact Information

	Karisa Nicole Gloudemans, DPT
	N2930 State Road 22, Wautoma, WI 54982-5267
	(920) 787-5030
	(920) 787-5372

Map and Direction

Healthcare Provider's Profile

Full Name	Karisa Nicole Gloudemans
Gender	Female
Speciality	Physical Therapist
Location	N2930 State Road 22, Wautoma, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1740963057
Provider Enumeration Date: 08/11/2023
Last Update Date: 11/25/2025

Medicare PECOS Information:

PECOS PAC ID: 2062867401
Enrollment ID: I20231005000063

Medical Identifiers

Medical identifiers for Karisa Nicole Gloudemans such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1740963057	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	16514-24 (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. Karisa Nicole Gloudemans allows following entities to bill medicare on her behalf.

Provider Name	Paxxon Healthcare Services Llc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1003174087 PECOS PAC ID: 8325959554 Enrollment ID: O20130917000750

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. Karisa Nicole Gloudemans 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
Karisa Nicole Gloudemans, DPT W6641 Rickey Ln, Greenville, WI 54942-8502 Ph: (920) 419-4767	Karisa Nicole Gloudemans, DPT N2930 State Road 22, Wautoma, WI 54982-5267 Ph: (920) 787-5030

Reviews and Comments

Physical Therapist in Wautoma, WI

Sean A Tillery, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: N2930 State Road 22, Wautoma, WI 54982 Phone: 920-787-5030 Fax: 920-787-5372
Karen A Aderhold-crass, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 900 E Division St, Wautoma, WI 54982 Phone: 920-787-6900 Fax: 920-787-6903
Emily M Marshall, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 900 E Division St, Wautoma, WI 54982 Phone: 920-787-6900
Eric A Gulbronson, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 900 E Division St, Wautoma, WI 54982 Phone: 920-787-6900
Emily Fenton, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 900 E Division St, Wautoma, WI 54982 Phone: 920-787-6900
Michael S Wingrove, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 900 E Division St, Wautoma, WI 54982 Phone: 920-787-6900

Karisa Nicole Gloudemans, DPT - Medicare Physical Therapist in Wautoma, WI