Individual provider Active NPI

Isaac Tubbesing, PT, DPT

  • Physical Therapist
  • South Sioux City, NE
National Provider Identifier
1154739001
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3338 Issued in NE
Practice address
601 W 29TH St Ste B
South Sioux City, NE 68776-3192
Phone
(402) 404-8005
Fax
(402) 791-6707
NPI assigned
Jul 23, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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 2073 SD
Physical Therapist 225100000X 3338 NE Primary

Addresses

Primary practice location

601 W 29TH St Ste B
South Sioux City, NE 68776-3192

Mailing address

601 W 29TH St Ste B
South Sioux City, NE 68776-3192
Phone (402) 404-8005

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230804002738 NE Practitioner - Physical Therapist in Private Practice 5890013288 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardinal Physical Therapy LLCGroup PAC ID 0840659785, 2 clinicians

Practice addresses (Care Compare)

601 W 29TH St
South Sioux City, NE 68776-3192
Phone (712) 635-7796

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cardinal Physical Therapy LLC Physical Therapist CurrentSince May 1, 2023 Accepting new patients

Locations

601 W 29th St
Ste B
South Sioux City, NE 68776
Phone (402) 404-8005

601 W 29th St
South Sioux City, NE 68776
Phone (712) 635-7796

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": "1406073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1154739001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 W 29TH ST STE B",
            "city": "SOUTH SIOUX CITY",
            "state": "NE",
            "postal_code": "687763192",
            "telephone_number": "402-404-8005",
            "fax_number": "402-791-6707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W 29TH ST STE B",
            "city": "SOUTH SIOUX CITY",
            "state": "NE",
            "postal_code": "687763192",
            "telephone_number": "402-404-8005",
            "fax_number": "402-791-6707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUBBESING",
        "first_name": "ISAAC",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-23",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SD",
            "license": "2073",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "3338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Sioux City, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2023; 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.