Individual provider Active NPI

Jason Robert Augustine, D.P.T.

  • Physical Therapist
  • Ankeny, IA
National Provider Identifier
1528084654
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
03779 Issued in IA
Practice address
1410 SW Tradition Dr Ste 290
Ankeny, IA 50023-9188
Phone
(515) 875-9706
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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 03779 IA Primary

Addresses

Primary practice location

1410 SW Tradition Dr Ste 290
Ankeny, IA 50023-9188

Mailing address

PO Box 424
Des Moines, IA 50302-0424
Phone (515) 875-9255

Other practice location 1

5950 University Ave Ste 285
West Des Moines, IA 50266
Phone (515) 875-9706

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jasonaugustine@tic.allscriptsdirect.net Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050504000822 IA Practitioner - Physical Therapist in Private Practice 8325088867 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Iowa Clinic PCGroup PAC ID 4082513742, 307 clinicians

Practice addresses (Care Compare)

1410 SW Tradition Dr
Suite 290
Ankeny, IA 50023-9188
Phone (515) 875-9100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3779IAMDDevelopmental - Behavioral Pediatrics Physician
03779IAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Iowa Physio LLC CurrentSince Aug 1, 2015 Accepting new patients
The Iowa Clinic, PC CurrentSince Mar 7, 2019 Accepting new patients
Central Iowa Physio, LLC CurrentSince Aug 1, 2015 Accepting new patients
The Iowa Clinic PC CurrentSince Mar 7, 2019 Accepting new patients
Excel Rehabilitation Inc Physical Therapist Past Accepting new patients

Locations

1410 SW Tradition Dr
Ste 290
Ankeny, IA 50023

1005 Pennsylvania Ave
Ste 102A
Ottumwa, IA 52501
Phone (641) 684-2589

1307 S Broadway St
Toledo, IA 52342
Phone (641) 484-5253

5950 University Ave
Ste 321
West Des Moines, IA 50266
Phone (515) 875-9178

5950 University Ave
Ste 285
West Des Moines, IA 50266
Phone (515) 875-9850

7147 Vista Dr
Ste 150
West Des Moines, IA 50266
Phone (515) 875-9255

Interoperability endpoints

  • Direct secure messaging: jasonaugustine@tic.allscriptsdirect.net

Organizations & group practices 5

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1528084654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 424",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503020424",
            "telephone_number": "515-875-9255",
            "fax_number": "515-875-9223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 SW TRADITION DR STE 290",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500239188",
            "telephone_number": "515-875-9706"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5950 University Ave Ste 285",
            "address_purpose": "LOCATION",
            "city": "West Des Moines",
            "state": "IA",
            "postal_code": "50266",
            "country_code": "US",
            "telephone_number": "515-875-9706",
            "fax_number": "515-875-9707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AUGUSTINE",
        "first_name": "JASON",
        "middle_name": "ROBERT",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "03779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jasonaugustine@tic.allscriptsdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5950 University Ave Ste 285",
            "city": "West Des Moines",
            "state": "IA",
            "country_code": "US",
            "postal_code": "50266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ankeny, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; 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.