Individual provider Active NPI

Andrea Wattier, PT,DPT

  • Physical Therapist
  • Grand Island, NE
National Provider Identifier
1144119165
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4817 Issued in NE
Practice address
905 N Custer Ave
Grand Island, NE 68803-4304
Phone
(308) 398-2170
Fax
(308) 398-5232
NPI assigned
Jul 2, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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 4817 NE Primary

Addresses

Primary practice location

905 N Custer Ave
Grand Island, NE 68803-4304

Mailing address

PO Box 5285
Grand Island, NE 68802-5285
Phone (308) 675-1853

Other names 1

  • Andrea Jagels Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250717002601 NE Practitioner - Physical Therapist in Private Practice 3072029065 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Go Physical Therapy LLCGroup PAC ID 0749258994, 98 clinicians

Practice addresses (Care Compare)

905 N Custer Ave
Grand Island, NE 68803-4304
Phone (308) 398-2170

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4817NEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Go Physical Therapy, LLC Physical Therapist CurrentSince Jul 7, 2025 Accepting new patients

Locations

620 N Diers Ave
Ste 300
Grand Island, NE 68803
Phone (308) 382-0344

905 N Custer Ave
Grand Island, NE 68803
Phone (308) 398-2170

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": "1751414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1144119165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5285",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688025285",
            "telephone_number": "308-675-1853",
            "fax_number": "308-210-4121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 N CUSTER AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034304",
            "telephone_number": "308-398-2170",
            "fax_number": "308-398-5232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTIER",
        "first_name": "ANDREA",
        "credential": "PT,DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-02",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "4817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "JAGELS",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Island, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2025; 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.