Individual provider Active NPI

Benjamin Paul Dewaard, MSPT

  • Orthopedic Physical Therapist
  • Lincoln, NE
National Provider Identifier
1356392849
Registry record updated Sep 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
2252 Issued in NE
Practice address
4920 N 26TH St
Suite 100
Lincoln, NE 68521-4748
Phone
(402) 434-5361
Fax
(402) 434-5365
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 2252 NE Primary

Addresses

Primary practice location

4920 N 26TH St
Suite 100
Lincoln, NE 68521-4748

Mailing address

1651 N 86TH St
Suite 100
Lincoln, NE 68505-3718
Phone (402) 484-7117

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040503001065 NE Practitioner - Physical Therapist in Private Practice 1658369301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1651 N 86TH St
Suite 100
Lincoln, NE 68505-3719
Phone (402) 484-7117

4920 N 26TH St
Suite 100
Lincoln, NE 68521-4748
Phone (402) 434-5361

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2252NEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lincoln Orthopedic Physical Therapy PC Orthopedic CurrentSince Jan 2, 2007 Accepting new patients
Lincoln Orthopedic Physical Therapy PC Orthopedic CurrentSince Jan 2, 2007 Accepting new patients
Crossroads Physical Therapy PC PastSince Apr 22, 2002 Accepting new patients

Locations

4920 N 26th St
Ste 100
Lincoln, NE 68521
Phone (402) 434-5361

1651 N 86th St
Ste 100
Lincoln, NE 68505
Phone (402) 484-7117

Organizations & group practices 3

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378857600000",
    "number": "1356392849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1651 N 86TH ST",
            "address_2": "SUITE 100",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685053718",
            "telephone_number": "402-484-7117",
            "fax_number": "402-484-7118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4920 N 26TH ST",
            "address_2": "SUITE 100",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685214748",
            "telephone_number": "402-434-5361",
            "fax_number": "402-434-5365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWAARD",
        "first_name": "BENJAMIN",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2013-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NE",
            "license": "2252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2013; 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.