Individual provider Active NPI

Jacob Patrick Brown, DPT

  • Pediatric Physical Therapist
  • Boys Town, NE
National Provider Identifier
1053264721
Registry record updated Feb 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
135779 Issued in IA
Practice address
14098 Mother Theresa Lane
Boys Town, NE 68010
Phone
(531) 355-8910
NPI assigned
Feb 20, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 135779 IA Primary

Addresses

Primary practice location

14098 Mother Theresa Lane
Boys Town, NE 68010

Mailing address

14098 Mother Theresa Lane
Boys Town, NE 68010

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260521002285 NE Practitioner - Physical Therapist in Private Practice 4385114172 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

14000 Boys Town Hospital Rd
Boys Town, NE 68010-7513

PO Box
Suite 110
Boys Town, NE 68010-0110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
135779IAMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Father Flanagan'S Boys' Home CurrentSince Apr 12, 2026 Accepting new patients

Locations

14098 Mother Teresa LN
Boys Town Pediatric Physical Therapy
Boys Town, NE 68010
Phone (531) 355-8910

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1771545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771545600000",
    "number": "1053264721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14098 MOTHER THERESA LANE",
            "city": "BOYS TOWN",
            "state": "NE",
            "postal_code": "68010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14098 MOTHER THERESA LANE",
            "city": "BOYS TOWN",
            "state": "NE",
            "postal_code": "68010",
            "telephone_number": "531-355-8910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JACOB",
        "middle_name": "PATRICK",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-02-20",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "IA",
            "license": "135779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boys Town, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2026; 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.