Individual provider Active NPI

Kurt M Walderbach, PT

  • Physical Therapist
  • Charles City, IA
National Provider Identifier
1578696993
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
01369 Issued in IA
Practice address
PO Box 93
Charles City, IA 50616-0093
Phone
(641) 715-1230
Fax
(641) 715-1231
NPI assigned
Mar 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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 01369 IA Primary

Addresses

Primary practice location

PO Box 93
Charles City, IA 50616-0093

Mailing address

PO Box 93
Charles City, IA 50616-0093
Phone (641) 715-1230

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040115000792 IA Practitioner - Physical Therapist in Private Practice 5193626943 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Iowa, RJ & L Carver College of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Synergy Physical Therapy and Sports Medicine PCGroup PAC ID 3476873282, 3 clinicians

Practice addresses (Care Compare)

318 N Main St
Charles City, IA 50616-2020
Phone (641) 715-1230

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01369IAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Physical Therapy & Sports Medicine, P.C. Physical Therapist CurrentSince Mar 16, 2015 Accepting new patients
Athletico LTD Physical Therapist Past Accepting new patients
McFarland Clinic, PC Past Accepting new patients

Locations

318 N Main St
Charles City, IA 50616
Phone (641) 715-1230

520 S Pierce Ave
Ste 224
Mason City, IA 50401
Phone (641) 421-8584

704 7th St N
Northwood, IA 50459
Phone (641) 323-7334

820 Sawyer Dr
Osage, IA 50461
Phone (641) 715-1230

Organizations & group practices 3

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": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1578696993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 93",
            "city": "CHARLES CITY",
            "state": "IA",
            "postal_code": "506160093",
            "telephone_number": "641-715-1230",
            "fax_number": "641-715-1231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 93",
            "city": "CHARLES CITY",
            "state": "IA",
            "postal_code": "506160093",
            "telephone_number": "641-715-1230",
            "fax_number": "641-715-1231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDERBACH",
        "first_name": "KURT",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "01369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charles City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.