NPIMap

Organization Active NPI

Nebraska Orthopaedic Physical Therapy PC

  • Physical Therapist
  • Fremont, NE
National Provider Identifier
1023041399
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
NEBRASKA ORTHOPAEDIC PHYSICAL THERAPY PC
Practice address
2123 E 23Rd Ave S
Fremont, NE 68025-2498
Phone
(402) 721-1112
Fax
(402) 721-1113
NPI assigned
Jul 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ross M Tessendorf, DPTNPI 1073539987
Title
Co-Owner
Phone
(402) 721-1112

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

2123 E 23Rd Ave S
Fremont, NE 68025-2498

Mailing address

2123 E 23Rd Ave S
Fremont, NE 68025-2498
Phone (402) 721-1112

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060823000543 NE Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2769485267 Receives reassigned benefits from 5 practitioners
Practice locations: Fremont, NE

National Provider Directory

National Provider Directory

Locations

2123 E 23rd Ave S
Fremont, NE 68025
Phone (402) 721-1112

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023041399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2123 E 23RD AVE S",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252498",
            "telephone_number": "402-721-1112",
            "fax_number": "402-721-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2123 E 23RD AVE S",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252498",
            "telephone_number": "402-721-1112",
            "fax_number": "402-721-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEBRASKA ORTHOPAEDIC PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TESSENDORF",
        "authorized_official_first_name": "ROSS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "402-721-1112",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.