Individual provider Active NPI

John Anthony Cervantes II, PT

  • Physical Therapist
  • Omaha, NE
National Provider Identifier
1114983947
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
894 Issued in NE
Practice address
1313 S Saddle Creek Rd
Omaha, NE 68106-2402
Phone
(402) 933-0100
NPI assigned
Apr 21, 2006
Last updated
Sep 3, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 894 NE Primary

Addresses

Primary practice location

1313 S Saddle Creek Rd
Omaha, NE 68106-2402

Mailing address

1313 S Saddle Creek Rd
Omaha, NE 68106-2402
Phone (402) 933-0100

Other identifiers 1

IdentifierTypeStateIssuer
47065477701MedicaidNE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110113000527 NE Practitioner - Physical Therapist in Private Practice 5799974317 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Nebraska College of Medicine, 1989
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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nannen Physical Therapy and Personal Training Physical Therapist CurrentSince May 23, 2025 Accepting new patients
Makovicka Harms Group PC Physical Therapist Past Accepting new patients
Affiliated Physical Therapy Physical Therapist Past Accepting new patients
Community Rehab LLC Physical Therapist Past Accepting new patients
Procare3, Inc. PastSince Jan 1, 2006 Accepting new patients

Locations

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

Organizations & group practices 5

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": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1114983947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 S SADDLE CREEK RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681062402",
            "telephone_number": "402-933-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 S SADDLE CREEK RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681062402",
            "telephone_number": "402-933-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERVANTES",
        "first_name": "JOHN",
        "middle_name": "ANTHONY",
        "name_suffix": "II",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-21",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47065477701",
            "state": "NE"
        }
    ],
    "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 Sep 3, 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.