Active NPI
Bryce A Exstrom, P.A.
- Physician Assistant
- Fremont, NE
National Provider Identifier
1003866237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 93
- Practice address
- 350 W 23Rd St
Suite D
Fremont, NE 68025-2592 - Phone
- (402) 721-8800
- Fax
- (402) 753-6096
- NPI assigned
- May 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 93 | NE | Primary |
Addresses
Primary practice location
350 W 23Rd St
Suite D
Fremont, NE 68025-2592
Mailing address
350 W 23Rd St
Suite D
Fremont, NE 68025-2592
Phone (402) 721-8800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 93 | NE | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Monty R. Sellon M.D. | Past | Accepting new patients | |
| Paul V. Glowacki MD LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Fremont, NE
- NPI 1073684239
-
- Family Medicine Physician
- Fremont, NE
- NPI 1235467036
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1003866237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "350 W 23RD ST",
"address_2": "SUITE D",
"city": "FREMONT",
"state": "NE",
"postal_code": "680252592",
"telephone_number": "402-721-8800",
"fax_number": "402-753-6096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 W 23RD ST",
"address_2": "SUITE D",
"city": "FREMONT",
"state": "NE",
"postal_code": "680252592",
"telephone_number": "402-721-8800",
"fax_number": "402-753-6096"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EXSTROM",
"first_name": "BRYCE",
"middle_name": "A",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-10",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NE",
"license": "93",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fremont, NE
- Chelsea Ellinghausen
- Becky Joy Ellsworth, PHARMD
- Mallory M Emken
- Amanda Nicole Esterling, APRN
- Michelle Eusterwiemann, OTR/L
- Eye Care Specialties PC of Lincoln
- Eyecare Specialties, PC of Lincoln
- Alicia Michelle Falcone, MS, PLMHP
- Family First Dental Associates of West Point, P.C.
- Family First Dentalassocciates of West Point, P.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.