Individual provider Active NPI

Suzanne Lynn Grotelueschen, PT, DPT

  • Physical Therapist
  • Omaha, NE
National Provider Identifier
1326420837
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60979906 Issued in WA
Practice address
13609 California St
Omaha, NE 68154-5260
Phone
(402) 891-1118
NPI assigned
Jun 19, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 22000 MA
Physical Therapist 225100000X 5501017215 MI
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X PT60979906 WA Primary
Physical Therapist 225100000X 142338 AK

Addresses

Primary practice location

13609 California St
Omaha, NE 68154-5260

Mailing address

2204 S 10TH St
Omaha, NE 68108-1107

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191001001328 WA Practitioner - Physical Therapist in Private Practice 1658654934 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22000MAMDPhysical Therapist
5501017215MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Rehabilitation Group, PC Single Specialty CurrentSince Jul 27, 2020 Accepting new patients
Apple Physical Therapy LLC Physical Therapist CurrentSince Sep 22, 2019 Accepting new patients
Highline Physical Therapy Group Single Specialty CurrentSince Oct 11, 2021 Accepting new patients
Integrated Rehabilitation Group, PC Physical Therapist CurrentSince Jul 27, 2020 Accepting new patients
Highline Physical Therapy Group Physical Therapist CurrentSince Oct 11, 2021 Accepting new patients
Cascade Rehabilitation Associates, PLLC Single Specialty CurrentSince Oct 11, 2021 Accepting new patients
Summit Rehabilitation PLLC Single Specialty CurrentSince Oct 11, 2021 Accepting new patients
Summit Rehabilitation PLLC Physical Therapist CurrentSince Oct 11, 2021 Accepting new patients
Apple Physical Therapy, LLC Single Specialty CurrentSince Sep 22, 2019 Accepting new patients
Cascade Rehabilitation Associates, PLLC Physical Therapist CurrentSince Oct 11, 2021 Accepting new patients
Ideal Rehabilitation LLC Past Accepting new patients

Locations

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

19119 North Creek Pkwy
Ste 107
Bothell, WA 98011
Phone (425) 486-8800

16259 Sylvester Rd SW
Burien, WA 98166
Phone (206) 241-5400

10207 19th Ave SE
Everett, WA 98208
Phone (425) 337-3166

4220 Hoyt Ave
Everett, WA 98203
Phone (425) 258-5330

10511 19th Ave SE
Ste B
Everett, WA 98208
Phone (425) 357-8885

32030 23rd Ave S
Federal Way, WA 98003
Phone (253) 946-4852

403 W Stanley St
Granite Falls, WA 98252
Phone (360) 691-4835

11800 NE 128th St
Ste 400
Kirkland, WA 98034
Phone (425) 820-0869

130 Marvin Rd SE
Ste 203
Lacey, WA 98503
Phone (360) 456-3300

9514 4th St NE
Unit 101
Lake Stevens, WA 98258
Phone (425) 397-2327

4220 132nd St SE
Ste 101
Mill Creek, WA 98012
Phone (425) 316-8046

12121 Harbour Reach Dr
Ste 100
Mukilteo, WA 98275
Phone (425) 354-5110

451 SW Sedgwick Rd
Ste 310
Port Orchard, WA 98367
Phone (360) 874-8009

231 Avenue D
Snohomish, WA 98290
Phone (360) 563-1020

Organizations & group practices 11

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": "1434672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1326420837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 S 10TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681081107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13609 CALIFORNIA ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681545260",
            "telephone_number": "402-891-1118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROTELUESCHEN",
        "first_name": "SUZANNE",
        "middle_name": "LYNN",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-19",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "22000",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501017215",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60979906",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "142338",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Aug 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.