Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
LEGACY PHYSIATRY GROUP WISCONSIN, LLC
Active
Organization
LEGACY PHYSIATRY GROUP WISCONSIN, LLC
Active
Other names
Legacy Physiatry Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIVEK SASTRY DO (PRESIDENT/CEO)
(972) 372-1663
Entity
Organization
Contact information
Practice address
200 S EXECUTIVE DR, SUITE 101, BROOKFIELD, WI 53005-4216
(972) 372-1663
Mailing address
850 CENTRAL PKWY E, SUITE 275, PLANO, TX 75074-5561
(972) 372-1663
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
NULL
207RC0000X
Cardiovascular Disease Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
NULL
207RP1001X
Pulmonary Disease Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
06/12/2015
Last updated
06/12/2015
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers