Individual provider Active NPI

Angie Nesrsta, PT

  • Physical Medicine & Rehabilitation Physician
  • Marble Falls, TX
National Provider Identifier
1245865088
Registry record updated Mar 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
1131399 Issued in TX
Practice address
608 Gateway Central
Marble Falls, TX 78654-6354
Phone
(830) 428-3044
NPI assigned
Mar 11, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X 1131399 TX Primary

Addresses

Primary practice location

608 Gateway Central
Marble Falls, TX 78654-6354

Mailing address

137 Broadmoor St
Meadowlakes, TX 78654-6622
Phone (214) 208-4750

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211018002958 TX Practitioner - Physical Therapist in Private Practice 4880092170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

608 Gateway Central
Suite 100
Marble Falls, TX 78654-6355
Phone (830) 428-3044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1131399TXMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hill Country Pelvic Health PLLC Single Specialty CurrentSince Sep 20, 2021 Accepting new patients
Amy Van Dorfy M D P a Single Specialty PastSince Mar 22, 2020 Accepting new patients

Locations

7401 W FM 2147
Ste 200
Horseshoe Bay, TX 78657
Phone (830) 428-3044

608 Gateway Central
Marble Falls, TX 78654
Phone (830) 428-3044

608 Gateway Central
Ste 100
Marble Falls, TX 78654
Phone (830) 428-3044

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": "1583884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583884800000",
    "number": "1245865088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 BROADMOOR ST",
            "city": "MEADOWLAKES",
            "state": "TX",
            "postal_code": "786546622",
            "telephone_number": "214-208-4750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 GATEWAY CENTRAL",
            "city": "MARBLE FALLS",
            "state": "TX",
            "postal_code": "786546354",
            "telephone_number": "830-428-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NESRSTA",
        "first_name": "ANGIE",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-11",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "1131399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marble Falls, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2020; 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.