Individual provider Active NPI

Nikolai Breitkopf, MSPT

  • Physical Therapist
  • Cheyenne, WY
National Provider Identifier
1174714232
Registry record updated Jul 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1105 Issued in WY
Practice address
1900 Converse Ave
Cheyenne, WY 82001-4112
Phone
(307) 514-2411
Fax
(307) 514-2392
NPI assigned
Aug 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2015

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 1105 WY Primary

Addresses

Primary practice location

1900 Converse Ave
Cheyenne, WY 82001-4112

Mailing address

PO Box 1790
Douglas, WY 82633-1790
Phone (307) 358-9464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY, NE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150729009212 WY Practitioner - Physical Therapist in Private Practice 2062726474 Reassigns benefits to 3 organizations
I20180321001991 NE Practitioner - Physical Therapist in Private Practice 2062726474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Sanford School of Medicine of University of South Dakota, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Platte Physical Therapy Services IncGroup PAC ID 8921080565, 34 clinicians

Practice addresses (Care Compare)

111 S 5TH St
Douglas, WY 82633-2434
Phone (307) 358-9464

3917 E Pershing Blvd
Cheyenne, WY 82001-6187
Phone (307) 514-2411

Merit-based Incentive Payment System (MIPS)

Final score
74.96 of 100Reported as group
Quality
70.73
Improvement activities
40
Cost
70.19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1105WYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Physical Therapy, LLC Physical Therapist CurrentSince Mar 1, 2018 Accepting new patients
North Platte Physical Therapy Services, Inc. Physical Therapist CurrentSince Aug 1, 2015 Accepting new patients
Bear Lodge Rehabilitation Services, LLC Physical Therapist CurrentSince Oct 1, 2015 Accepting new patients
Memorial Hospital of Converse County Past Accepting new patients
Northplatte Physical Therpy Services Inc Physical Therapist Past Accepting new patients

Locations

3315 10th St
Gering, NE 69341
Phone (308) 633-5361

311 Thelma Dr
Casper, WY 82609
Phone (307) 234-2334

3831 Denis Dr
Ste 200
Casper, WY 82604
Phone (307) 234-9067

3917 E Pershing Blvd
Cheyenne, WY 82001
Phone (307) 514-2411

7226 Commons Dr
Ste B
Cheyenne, WY 82009
Phone (307) 514-5834

111 S 5th St
Douglas, WY 82633
Phone (307) 358-6200

1115 Lane 12
Lovell, WY 82431
Phone (307) 548-2771

777 Avenue H
Powell, WY 82435
Phone (307) 754-1175

1301 E M St
Torrington, WY 82240
Phone (307) 532-5355

Organizations & group practices 6

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": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437091200000",
    "number": "1174714232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1790",
            "city": "DOUGLAS",
            "state": "WY",
            "postal_code": "826331790",
            "telephone_number": "307-358-9464",
            "fax_number": "307-358-9330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 CONVERSE AVE",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820014112",
            "telephone_number": "307-514-2411",
            "fax_number": "307-514-2392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREITKOPF",
        "first_name": "NIKOLAI",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-05",
        "last_updated": "2015-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WY",
            "license": "1105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; 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.