Individual provider Active NPI

Nicholas S Krueger, DPT

  • Physical Therapist
  • Omaha, NE
National Provider Identifier
1114578614
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4017 Issued in NE
Practice address
9449 J St
Omaha, NE 68127-1218
Phone
(402) 593-7345
Fax
(402) 593-0882
NPI assigned
Sep 25, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

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 098407 IA
Physical Therapist 225100000X 4017 NE Primary

Addresses

Primary practice location

9449 J St
Omaha, NE 68127-1218

Mailing address

600 Oakmont LN Ste 600C
Westmont, IL 60559-5548
Phone (630) 575-1980

Other practice location 1

301 W Broadway Ste 100
Council Bluffs, IA 51503-9071
Phone (712) 322-9688

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191031001679 NE Practitioner - Physical Therapist in Private Practice 1355673948 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nannen Physical Therapy and Personal TrainingGroup PAC ID 9931152402, 9 clinicians

Practice addresses (Care Compare)

636 N 20TH Ave
Blair, NE 68008-1116
Phone (402) 426-3488

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4017NEMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Sep 1, 2021 Accepting new patients
Nannen Physical Therapy and Personal Training Physical Therapist CurrentSince Apr 26, 2023 Accepting new patients

Locations

636 N 20th Ave
Blair, NE 68008
Phone (402) 426-3488

603 N Diers Ave
Ste 1
Grand Island, NE 68803
Phone (308) 389-4418

5633 S 16th St
Ste 600
Lincoln, NE 68512
Phone (402) 817-1750

333 S 132nd St
Omaha, NE 68154
Phone (402) 330-2024

9449 J St
Omaha, NE 68127
Phone (402) 330-8433

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.

NPI Registry JSON

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

{
    "created_epoch": "1569369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1114578614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 OAKMONT LN STE 600C",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595548",
            "telephone_number": "630-575-1980",
            "fax_number": "630-928-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9449 J ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681271218",
            "telephone_number": "402-593-7345",
            "fax_number": "402-593-0882"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 W Broadway Ste 100",
            "address_purpose": "LOCATION",
            "city": "Council Bluffs",
            "state": "IA",
            "postal_code": "515039071",
            "country_code": "US",
            "telephone_number": "712-322-9688",
            "fax_number": "712-322-1299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "NICHOLAS",
        "middle_name": "S",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-25",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "098407",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "4017",
            "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 Nov 26, 2019; 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.