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

Blake Randall Van Maanen

Individual provider Physical Therapist · NPI 1659998284

Blake Randall Van Maanen is a Physical Therapist in Private Practice in Menomonee Falls, Wisconsin. Qualified in 2020, 6 years ago. Practices with Froedtert Andthe Medical College of Wisconsin Community Physicians Inc, a 1,255-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
6
Licensed in
WI
In the registry since
2020
Specialties on file
2
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

N91W15750 Falls Pkwy
Menomonee Falls, WI 53051-2301
Phone: (262) 532-1100
Fax: (262) 532-1409
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 15128-24 (WI)
Physical Therapist Taxonomy 225100000X

Record details

NPI number1659998284
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJune 30, 2020
Last updated in NPPESApril 13, 2026
Certification dateApril 13, 2026
Mailing address2651 Marathon Ave, Neenah, WI 54956-5080

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Froedtert Andthe Medical College Of Wisconsin Community Physicians Inc — 1255 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Menomonee Falls