Individual provider Active NPI

Forrest Anshutz, PT

  • Physical Therapist
  • Brookings, SD
National Provider Identifier
1669439188
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0389 Issued in SD
Practice address
302 W 6TH St
Brookings, SD 57006-1159
Phone
(605) 692-8848
Fax
(605) 692-8849
NPI assigned
Apr 27, 2006
Last updated
Apr 27, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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 0389 SD Primary

Addresses

Primary practice location

302 W 6TH St
Brookings, SD 57006-1159

Mailing address

302 W 6TH St
Brookings, SD 57006-1159
Phone (605) 692-8848

Other identifiers 2

IdentifierTypeStateIssuer
5830704MedicaidSD
P00603949OtherSDRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20061228000113 SD Practitioner - Physical Therapist in Private Practice 4880680875 Reassigns benefits to 1 organization
I20260323001024 TX Practitioner - Physical Therapist in Private Practice 4880680875 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pro PT, Inc.Group PAC ID 8325139041, 4 clinicians
Flandreau Santee Sioux TribeGroup PAC ID 0840376380, 11 clinicians

Practice addresses (Care Compare)

302 W 6TH St
Brookings, SD 57006-1159
Phone (605) 692-8848

403 W Broad Ave
Flandreau Santee Sioux Tribal
Flandreau, SD 57028-1630
Phone (605) 997-2642

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pro PT, Inc. Physical Therapist CurrentSince Aug 16, 2006 Accepting new patients

Locations

302 W 6th St
Brookings, SD 57006
Phone (605) 203-3198

1552 Dakota Ave S
Huron, SD 57350
Phone (605) 352-9498

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1669439188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 W 6TH ST",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570061159",
            "telephone_number": "605-692-8848",
            "fax_number": "605-692-8849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 W 6TH ST",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570061159",
            "telephone_number": "605-692-8848",
            "fax_number": "605-692-8849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANSHUTZ",
        "first_name": "FORREST",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SD",
            "license": "0389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5830704",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00603949",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookings, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; 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.