Individual provider Active NPI

Trevor C Anderson, DPT

  • Physical Therapist
  • Omaha, NE
National Provider Identifier
1407348550
Registry record updated Jun 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
9449 J St
Omaha, NE 68127-1218
Phone
(402) 593-7345
Fax
(402) 593-0882
NPI assigned
Jun 5, 2018
Last updated
Jun 5, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2018

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 NU Primary

Addresses

Primary practice location

9449 J St
Omaha, NE 68127-1218

Mailing address

600 Oakmont LN Ste 600C
Westmont, IL 60559-5548
Phone (630) 575-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180712002407 NE Practitioner - Physical Therapist in Private Practice 4183970692 Reassigns benefits to 1 organization
I20180731002023 IA Practitioner - Physical Therapist in Private Practice 4183970692 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

2206 Longo Dr
Suite 211
Bellevue, NE 68005-2977
Phone (402) 291-1963

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
092809IAMDAmbulatory Women's Health Care Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Apr 1, 2019 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Apr 1, 2019 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Sep 1, 2021 Accepting new patients
Athletico LTD Physical Therapist Past Accepting new patients

Locations

3252 Ridge Pt
Bettendorf, IA 52722
Phone (563) 332-4995

2918 E University Ave
Des Moines, IA 50317
Phone (515) 265-8272

600 Oakmont Ln
Ste 600C
Westmont, IL 60559
Phone (630) 575-6250

2206 Longo Dr
Ste 211
Bellevue, NE 68005
Phone (402) 291-1963

603 N Diers Ave
Ste 1
Grand Island, NE 68803
Phone (308) 389-4418

5633 S 16th St
Ste 600
Lincoln, NE 68512
Phone (402) 817-1750

9449 J St
Omaha, NE 68127
Phone (402) 330-8433

1226 N Washington St
Ste 1
Papillion, NE 68046
Phone (402) 593-1734

Organizations & group practices 4

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": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528156800000",
    "number": "1407348550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 OAKMONT LN STE 600C",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595548",
            "telephone_number": "630-575-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9449 J ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681271218",
            "telephone_number": "402-593-7345",
            "fax_number": "402-593-0882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "TREVOR",
        "middle_name": "C",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-05",
        "last_updated": "2018-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "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 Jun 5, 2018; 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.