Providers
All 29 in WI
WISCONSIN CHRONIC PAIN PHYSICAL THERAPY, INC
NPI 1720557135, organization, Wauwatosa, WI, Clinic/Center, Physical Therapy
1
Evidence tier
documented action, then payment
- Listed on the Medicare revocation list since December 10, 2021.
- Medicaid still paid claims in 1 later month, $1,434 in total.
score 93 of 100, rank 380, $1K at stake
Public list actions
Medicare revocation effective December 10, 2021, barred from re-enrolling until December 10, 2031
424.535(a)(9) failure to report and 424.535(a)(3) felonies and 424.535(a)(2) provider or supplier conduct (exclusion), Part B Supplier - Physical/Occupational Therapy Group In Private Practice, WI
Paid after the action
Months in which Medicaid paid claims for this provider after a public action that should have triggered a screening check. This is a record of payments, not a determination that they were improper.
| list | identity check | action date | window closed | months paid after | first | last | paid after | 12 months before |
|---|---|---|---|---|---|---|---|---|
| Medicare revocation list 424.535(a)(9) failure to report and 424.535(a)(3) felonies and 424.535(a)(2) provider or supplier conduct (exclusion) | Exact NPI, name verified | Dec 10, 2021 | Dec 10, 2031 | 1 | Jun 2022 | Jun 2022 | $1K | $9K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | WISCONSIN CHRONIC PAIN PHYSICAL THERAPY, INC |
| Type | Organization |
| Status | Active |
| NPI issued | November 14, 2018, last updated October 12, 2022 |
| Practice location | 2500 N MAYFAIR RD STE 300, Wauwatosa, WI 53226-1415, 414-800-5359 |
| Authorized official | HEIDI RICHBURG (President & CEO) |
| Specialties | Clinic/Center, Physical Therapy (261QP2000X, primary) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
Medicaid, largest codes
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 97140 | Therapy procedure using manual technique, each 15 minutes | $7K | 62% | $157 | $47 (top 5% from $120) | too few months to rank | |
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | $3K | 25% | $70 | $76 (top 5% from $314) | too few months to rank | |
| 97112 | Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | $1K | 13% | $120 | $59 (top 5% from $187) | too few months to rank |
In this area
29 providers in Milwaukee County, WI carry an indicator in the public record, with $11.4M at stake between them. The most common is part of a provider network, on 12 of them, followed by more hours than a day holds on 11. 4 are tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | GRO FAMILY SERVICES LLC Milwaukee, WI, ranked 234 | $23K |
|
| 1 | NOAH ASSOCIATES INCORPORATED West Allis, WI, ranked 574 | $0 |
|
| 1 | CARING THROUGH LOVE LLC Milwaukee, WI, ranked 615 | $0 |
|
| 1 | HERE FOR YOU PRENATAL COORDINATION SERVICES LLC West Allis, WI, ranked 633 | $0 |
|
| 3 | ST. CAMILLUS HEALTH CENTER, INC. Wauwatosa, WI, ranked 2180 | $0 |
|
| 3 | WE CARE SERVICES LLC Milwaukee, WI, ranked 2561 | $0 |
|
| 3 | ST. CAMILLUS HEALTH CENTER, INC. Wauwatosa, WI, ranked 2611 | $0 |
|
| 3 | UNITED LUTHERAN PROGRAM FOR THE AGING, INC Wauwatosa, WI, ranked 2779 | $0 |
|
Recent enforcement in WI
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJChargedJun 25, 2026
Federal Charges Announced in Multi-Million Dollar Medicaid Fraud Scheme and Prescription Drug Diversion Conspiracy; Announcement Made as Part of Justice Department’s National Health Care Fraud Takedown
Cooper submitted over $5.8 million in false claims to Wisconsin Medicaid for prenatal care coordination services that beneficiaries never received and used another person's means of identification, while Jones conspired to distribute controlled substances outside the usual course of professional practice.
DOJCivil settlementApr 17, 2026
Appleton Clinic to Pay Over $380,000 to Resolve False Claims Act Allegations Relating to the Marketing and Use of Electric Stimulation Devices
Apple Medical Clinic and its principal caused the submission of false claims to Medicare for electrical muscle stimulation, vitamin injections, and other related services that were not medically reasonable or necessary, and marketed the Sanexas device outside its FDA clearance and contrary to coverage determinations.
DOJSentencedMar 23, 2026
Owner of Now-Closed Milwaukee Prenatal Care Coordination Company Sentenced to 60 Months’ Imprisonment for Healthcare Fraud Scheme
Jackson offered women kickbacks in exchange for their Medicaid numbers and falsely billed Wisconsin Medicaid for prenatal care coordination services, almost always at the monthly maximum, when she and her employees provided few to no covered services.
DOJCivil settlementMar 5, 2026
Waukesha Medical Equipment Company Agrees to Pay Nearly $7 Million to Resolve Allegations of False Billings to Federal Healthcare Programs
From 2019 through 2024, Kinex provided patients covered by federal programs with medical braces the patients did not need and billed Medicare, TRICARE, FEHBP, and OWCP as if the braces had been necessary, inducing patients to accept them by waiving co-pays and giving free equipment.
DOJSentencedFeb 3, 2026
Delafield Man Sentenced to 18 Months’ Imprisonment for Conspiracy to Pay Healthcare Kickbacks
Johnson paid kickbacks to companies purporting to provide marketing services in exchange for signed prescriptions and doctors' orders for durable medical equipment that his company Kestrel Medical submitted to Medicare.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.