Individual provider Active NPI

Nicholas J Reiss, PT

  • Physical Therapist
  • Lincoln, NE
National Provider Identifier
1619015013
Registry record updated Aug 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1913 Issued in NE
Practice address
3818 Normal Boulevard
Lincoln, NE 68506
Phone
(402) 488-4282
Fax
(402) 488-6157
NPI assigned
Feb 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2007

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 1913 NE Primary

Addresses

Primary practice location

3818 Normal Boulevard
Lincoln, NE 68506

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
650026107OtherNERAILROAD MEDICARE
39628OtherNEBCBS
10024956500MedicaidNE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071004000665 NE Practitioner - Physical Therapist in Private Practice 7810082930 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Complete Physical Therapy LLCGroup PAC ID 7416108766, 5 clinicians

Practice addresses (Care Compare)

4220 Pioneer Woods Dr
Lincoln, NE 68506-7564
Phone (402) 483-0006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1913NEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Physical Therapy LLC Physical Therapist CurrentSince Oct 1, 2012 Accepting new patients
Nebraska City Physical Therapy, LLC Physical Therapist PastSince Sep 1, 2022 Accepting new patients
Exstrom Physical Therapy Inc Physical Therapist PastSince Apr 1, 2003 Accepting new patients

Locations

4220 Pioneer Woods Dr
Lincoln, NE 68506
Phone (402) 483-0006

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": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186099200000",
    "number": "1619015013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3818 NORMAL BOULEVARD",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "68506",
            "telephone_number": "402-488-4282",
            "fax_number": "402-488-6157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3818 NORMAL BOULEVARD",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "68506",
            "telephone_number": "402-488-4282",
            "fax_number": "402-488-6157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISS",
        "first_name": "NICHOLAS",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "1913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "650026107",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "39628",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10024956500",
            "state": "NE"
        }
    ],
    "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 Aug 3, 2007; 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.