Wyatt Bradley Amdahl, PT, DPT
Individual provider Active NPI Physical Therapist · Bottineau, ND
NPI 1336964477 · NPPES record last updated Nov 21, 2024
Key facts
- NPI
- 1336964477
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- Practice address
- 226 Westergard Rd
Bottineau, ND 58318-8058 - Phone
- (218) 240-4927
- NPI assigned
- Nov 21, 2024
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- S.a.C. Physical Therapy PC
Practice addresses (Care Compare)
1103 Butte House Rd
Suite D
Yuba City, CA 95991-3109
Phone (530) 324-8490
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250320002551 | CA | Practitioner - Physical Therapist in Private Practice | 0345762175 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| S.a.C. Physical Therapy, P.C. | Current |
Accepting new patients |
Locations
1103 Butte House Rd
Ste D
Yuba City, CA 95991
Phone (530) 324-8490
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | CA | Yes |
Addresses
Primary practice location
226 Westergard Rd
Bottineau, ND 58318-8058
Mailing address
226 Westergard Rd
Bottineau, ND 58318-8058
Phone (218) 240-4927
Other providers in Bottineau, ND
- Kyle James Arends
- Stephanie Ann Arends
- Amanda Kay Dukart Beckman
- Heather Belcourt
- Berentson Psychological Services, PLLC
All providers in Bottineau, ND · Physical Therapist in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 21, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.