Individual provider Active NPI

Lexi Marie Yagodinski

  • Physical Therapy Assistant
  • Papillion, NE
National Provider Identifier
1053184515
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
1913 Issued in NE
Practice address
545 Fortune Dr
Papillion, NE 68046-3426
Phone
(402) 991-0333
NPI assigned
Nov 6, 2023
Last updated
Nov 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 1913 NE Primary

Addresses

Primary practice location

545 Fortune Dr
Papillion, NE 68046-3426

Mailing address

4614 S 132ND St
Omaha, NE 68137-1764

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1913NEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Procare3, Inc. CurrentSince Nov 12, 2023 Accepting new patients

Locations

4614 S 132nd St
Omaha, NE 68137
Phone (402) 330-3211

545 Fortune Dr
Papillion, NE 68046
Phone (402) 991-0333

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1053184515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4614 S 132ND ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681371764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 FORTUNE DR",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680463426",
            "telephone_number": "402-991-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAGODINSKI",
        "first_name": "LEXI",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NE",
            "license": "1913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Papillion, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.