Trevor Samuel Bandiera, PT, DPT
Individual provider Active NPI Physical Therapist · Omaha, NE
NPI 1730019985 · NPPES record last updated May 20, 2026
Key facts
- NPI
- 1730019985
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 4880 (NE)
- Practice address
- 360 N 114TH St
Omaha, NE 68154-2517 - Phone
- (402) 740-8400
- Fax
- (402) 547-4200
- NPI assigned
- May 20, 2026
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
16608 Josephine St
Omaha, NE 68136-3064
360 N 114TH St
Omaha, NE 68154-2517
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NE
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260604002196 | NE | Practitioner - Physical Therapist in Private Practice | 1850862459 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4880 | NE | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Rehab Guru, P.C. | Physical Therapist | Current |
Accepting new patients |
| Omaha Eyecare | Past |
Accepting new patients |
Locations
2730 S 114th St
Omaha, NE 68144
Phone (402) 333-2244
360 N 114th St
Omaha, NE 68154
Phone (402) 740-8400
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4880 | NE | Yes |
Addresses
Primary practice location
360 N 114TH St
Omaha, NE 68154-2517
Mailing address
360 N 114TH St
Omaha, NE 68154-2517
Phone (402) 740-8400
Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.