Individual provider Active NPI

Allen Gary Laubenthal

  • Physical Therapist
  • West Des Moines, IA
National Provider Identifier
1396975124
Registry record updated Jul 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
03444 Issued in IA
Practice address
1454 30TH St
Suite 103
West Des Moines, IA 50266-1305
Phone
(515) 223-6620
Fax
(515) 223-9625
NPI assigned
Jul 14, 2009
Last updated
Jul 14, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2009

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 03444 IA Primary

Addresses

Primary practice location

1454 30TH St
Suite 103
West Des Moines, IA 50266-1305

Mailing address

1454 30TH St
Suite 103
West Des Moines, IA 50266-1305
Phone (515) 223-6620

Other identifiers 1

IdentifierTypeStateIssuer
0665190MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200414000936 IA Practitioner - Physical Therapist in Private Practice 8022448174 Reassigns benefits to 2 organizations

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
Dae, Inc.Group PAC ID 9133257645, 5 clinicians

Practice addresses (Care Compare)

402 W Burlington Ave
Suite 200
Fairfield, IA 52556-3243
Phone (641) 469-3130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Gay Hospital, Inc CurrentSince Jun 10, 2025 Accepting new patients
Dae, Inc. Physical Therapist CurrentSince May 1, 2020 Accepting new patients

Locations

401 Cardinal Ave
Atkins, IA 52206
Phone (319) 446-6231

402 W Burlington Ave
Ste 200
Fairfield, IA 52556
Phone (641) 469-3130

502 N 9th Ave
Vinton, IA 52349
Phone (319) 472-6200

1454 30th St
Ste 103
West Des Moines, IA 50266
Phone (515) 223-6620

11623 Arbor St
Ste 200
Omaha, NE 68144
Phone (402) 334-1919

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, 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": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247529600000",
    "number": "1396975124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1454 30TH ST",
            "address_2": "SUITE 103",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661305",
            "telephone_number": "515-223-6620",
            "fax_number": "515-223-9625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1454 30TH ST",
            "address_2": "SUITE 103",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661305",
            "telephone_number": "515-223-6620",
            "fax_number": "515-223-9625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUBENTHAL",
        "first_name": "ALLEN",
        "middle_name": "GARY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-14",
        "last_updated": "2009-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "03444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0665190",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2009; 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.