Ellen Grandaw Martin
Physical Therapist · Random Lake, WI
Ellen Grandaw Martin is a physical therapist with a practice address in Random Lake, Wisconsin, and NPI 1902572571, issued on Aug 23, 2021. Check the license (Wisconsin 4431-24, as entered in NPPES) with the Wisconsin board that licenses this profession; the Medicare figures below come from public CMS files.
- Name
- Ellen Grandaw Martin
- Primary taxonomy
- Physical Therapist 225100000X
- License number
- 4431-24 WI
Self-reported in NPPES; status is on the state search - Practice location
- 621 Spring CT, Random Lake, WI 53075
- Phone
- (920) 960-0505
- Enumerated
- Aug 23, 2021
- Record last updated
- Aug 23, 2021 (not updated in 5 years: call before relying on the address or phone)
- Medicare enrollment
- Enrolled (PECOS I20211019002174); accepts Medicare assignment
- Medical or professional school
- University Of Wisconsin School Of Medicine, 1992
- Entity
- Type 1 · individual
Verify Ellen Grandaw Martin in five checks
- 1IdentityNPI record in CMS NPPESNPI lookupConfirmed in NPPES
- 2LicenseActive license and public ordersWhich Wisconsin board licenses this profession
Search for license 4431-24Check the board - 3Other statesLicenses and actions elsewhereDocInfo (FSMB)Not checked
- 4ExclusionsMedicare and Medicaid bansHHS-OIG exclusion listNot checked
- 5CertificationBoard certificationABMS AOA NCCPA AANPNot checked
Bills Medicare through one group practice
- Aegis Group Practice LLCPort Washington, WI
Source: CMS Doctors and Clinicians National Downloadable File (the group practices a clinician bills Medicare through) (data.cms.gov).
7 physical therapist records list a practice address in Random Lake
They are 7 of the 27 NPPES records with a practice address in Random Lake, and 6,585 physical therapist records in Wisconsin.
All 7 in Random Lake → All 6,585 in Wisconsin → Every provider in Random Lake →
Other physical therapist records in Wisconsin
- Jared Aarsvold, PT, DPTAltoona, WI1356208060
- Delia Abano, PTRhinelander, WI1780028852
- Mikayla Abbeduto, DPTWaukesha, WI1316513955
- Michelle Abbott, PT, DPTHudson, WI1508725698
- Nicole Abdo, DPTGreen Bay, WI1225315096
- Heather AbelsElkhorn, WI1760598064
- Kelsey Abendroth, PTNew London, WI1548783228
- Paul Abler, P.T.Hartland, WI1235281254
- Nada Abouelnaga, DPTAmery, WI1902632045
- Anne Abraham, PTMadison, WI1205903523
Common questions
What is Ellen Grandaw Martin's NPI number?
Ellen Grandaw Martin's National Provider Identifier (NPI) is 1902572571, issued on Aug 23, 2021. An NPI identifies a provider in billing; it is not a license.
Where is Ellen Grandaw Martin located?
The NPPES record lists a practice address at 621 Spring CT, Random Lake, WI, 53075. Phone: (920) 960-0505. Providers update this record themselves, so call before visiting.
How can I verify Ellen Grandaw Martin's license?
NPPES lists Wisconsin license number 4431-24, as entered by the provider. Search the Wisconsin board that licenses this profession; the NPPES record confirms identity only.
Source: CMS National Plan and Provider Enumeration System (NPPES), file of Aug 9, 2026 (NPPES files on CMS.gov); NUCC Health Care Provider Taxonomy. Medicare files from data.cms.gov. An NPI identifies who bills; it is not a license.
Figures on PlainDoctor are read from the federal files each page names (CMS NPPES, Medicare Part D, MIPS, Open Payments; the HHS-OIG exclusion list only as counts) and from Census population estimates, with the file date shown beside them. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of Aug 9, 2026.