Individual provider Active NPI

Susan O Riley

  • Pediatric Physical Therapist
  • Omaha, NE
National Provider Identifier
1013056076
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
4578 Issued in NE
Practice address
985450 Nebraska Medical Ctr
Omaha, NE 68198-5724
Phone
(402) 559-8943
Fax
(402) 559-5753
NPI assigned
Feb 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 3575 MA
Pediatric Physical Therapist 2251P0200X 4578 NE Primary

Addresses

Primary practice location

985450 Nebraska Medical Ctr
Omaha, NE 68198-5724

Mailing address

985450 Nebraska Medical Ctr
Omaha, NE 68198-5450
Phone (404) 559-8943

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241104002510 NE Practitioner - Physical Therapist in Private Practice 1759814387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Nebraska Board of RegentsGroup PAC ID 3971564279, 44 clinicians

Practice addresses (Care Compare)

6902 Pine St
Omaha, NE 68106-2855
Phone (402) 559-6418

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4578NEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
University of Nebraska Board of Regents CurrentSince Oct 1, 2024 Accepting new patients
University of Nebraska Board of Regents CurrentSince Oct 1, 2024 Accepting new patients
University of Nebraska Board of Regents Past Accepting new patients

Locations

6902 Pine St
Omaha, NE 68106
Phone (402) 559-6418

985450 Nebraska Medical Ctr
Omaha, NE 68198
Phone (402) 559-6408

444 S 44th St
Omaha, NE 68131
Phone (402) 559-3563

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1013056076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "985450 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681985450",
            "telephone_number": "404-559-8943",
            "fax_number": "402-559-5753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "985450 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681985724",
            "telephone_number": "402-559-8943",
            "fax_number": "402-559-5753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "SUSAN",
        "middle_name": "O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "3575",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NE",
            "license": "4578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.