Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Legacy Physiatry Group Wisconsin, LLC

Organization Internal Medicine Physician · NPI 1275914483

Legacy Physiatry Group Wisconsin, LLC is an Internal Medicine Physician in Brookfield, Wisconsin. Registered with an NPI since 2015.

In the registry since
2015
Specialties on file
6
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

200 S Executive Dr Ste 101
Brookfield, WI 53005-4216
Phone: (972) 372-1663
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X
Internal Medicine Physician Taxonomy 207R00000X
Cardiovascular Disease Physician Taxonomy 207RC0000X
Pulmonary Disease Physician Taxonomy 207RP1001X
Physician Assistant Taxonomy 363A00000X
Nurse Practitioner Taxonomy 363L00000X

Record details

NPI number1275914483
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Vivek Sastry — President/Ceo · (972) 372-1663
Other names Legacy Physiatry Group
NPI enumeratedJune 12, 2015
Last updated in NPPESJune 12, 2015
Mailing address850 Central Pkwy E, Suite 275, Plano, TX 75074-5561

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