Individual provider Active NPI

Kaley Brandenburg, DPT

  • Physical Therapist
  • Lincoln, NE
National Provider Identifier
1578436770
Registry record updated Dec 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4867 Issued in NE
Practice address
4220 Lucile Dr Ste 3
Lincoln, NE 68506-6004
Phone
(402) 327-9000
Fax
(402) 327-9003
NPI assigned
Sep 25, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2025

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 4867 NE Primary

Addresses

Primary practice location

4220 Lucile Dr Ste 3
Lincoln, NE 68506-6004

Mailing address

4220 Lucile Dr Ste 3
Lincoln, NE 68506-6004
Phone (402) 327-9000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251010001389 NE Practitioner - Physical Therapist in Private Practice 9739686130 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Nebraska College of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proformance Physical Therapy and Sports Rehab, P.C.Group PAC ID 7911900071, 5 clinicians

Practice addresses (Care Compare)

4220 Lucile Dr
Suite 3
Lincoln, NE 68506-6004
Phone (402) 327-9000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4867NEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Proformance Physical Therapy and Sports Rehab, P.C. Physical Therapist CurrentSince Sep 24, 2025 Accepting new patients

Locations

4220 Lucile Dr
Lincoln, NE 68506
Phone (402) 421-1411

4220 Lucile Dr
Ste 3
Lincoln, NE 68506
Phone (402) 327-9000

Organizations & group practices 1

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": "1758758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765497600000",
    "number": "1578436770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4220 LUCILE DR STE 3",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685066004",
            "telephone_number": "402-327-9000",
            "fax_number": "402-327-9003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 LUCILE DR STE 3",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685066004",
            "telephone_number": "402-327-9000",
            "fax_number": "402-327-9003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDENBURG",
        "first_name": "KALEY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-25",
        "last_updated": "2025-12-12",
        "certification_date": "2025-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "4867",
            "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 Dec 12, 2025; 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.