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

Tanner J Deist, PT

Individual provider Physical Therapist · NPI 1790678944

Tanner J Deist, PT is a Physical Therapist in Private Practice in Plymouth, Wisconsin. Qualified in 2025, 1 year ago. Practices with Aurora Medical Group, Inc, a 3,741-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
1
Licensed in
WI
In the registry since
2025
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

2600 Kiley Way
Plymouth, WI 53073-5020
Phone: (920) 449-7120
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 17161-24 (WI)

Record details

NPI number1790678944
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorNo
NPI enumeratedMay 29, 2025
Last updated in NPPESAugust 28, 2025
Certification dateAugust 28, 2025
Mailing addressPo Box 735044, Chicago, IL 60673-5044

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Aurora Medical Group, Inc. — 3741 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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