Individual provider Active NPI

Anthony J Hentzen, PT

  • Physical Therapist
  • Omaha, NE
National Provider Identifier
1497188643
Registry record updated Aug 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3280 Issued in NE
Practice address
1021 S 178TH St
Suite 101
Omaha, NE 68118-3574
Phone
(402) 933-3036
Fax
(402) 933-3163
NPI assigned
Aug 12, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2015

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 3280 NE Primary

Addresses

Primary practice location

1021 S 178TH St
Suite 101
Omaha, NE 68118-3574

Mailing address

607 Dewey Nwave 300
Grand Rapids, MI 49504-7335
Phone (913) 904-1128

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131016000954 NE Practitioner - Physical Therapist in Private Practice 5991939449 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Nebraska College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nebraska City Physical Therapy LLCGroup PAC ID 4486836301, 12 clinicians

Practice addresses (Care Compare)

510 Bradford St
Suite B
Seward, NE 68434-1709
Phone (402) 646-2007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3280NEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nebraska City Physical Therapy, LLC Physical Therapist CurrentSince Jun 22, 2022 Accepting new patients
Havelock Physical Therapy LLC Physical Therapist PastSince Dec 19, 2016 Accepting new patients
Makovicka Harms Group, PC Physical Therapist Past Accepting new patients
Pacific Springs Physical Therapy, PC Physical Therapist Past Accepting new patients

Locations

6319 Havelock Ave
Lincoln, NE 68507
Phone (402) 325-0044

3818 Normal Blvd
Lincoln, NE 68506
Phone (402) 488-4282

1104 Grundman Blvd
Nebraska City, NE 68410
Phone (402) 873-7411

510 Bradford St
Ste B
Seward, NE 68434
Phone (402) 646-2007

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1376265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438646400000",
    "number": "1497188643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 DEWEY NWAVE 300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495047335",
            "telephone_number": "913-904-1128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 S 178TH ST",
            "address_2": "SUITE 101",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681183574",
            "telephone_number": "402-933-3036",
            "fax_number": "402-933-3163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENTZEN",
        "first_name": "ANTHONY",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-12",
        "last_updated": "2015-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "3280",
            "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 Aug 4, 2015; 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.