Individual provider Active NPI

Susan Elizabeth Siegmund, DPT

  • Physical Therapist
  • Omaha, NE
National Provider Identifier
1740205103
Registry record updated Feb 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2446 Issued in NE
Practice address
5030 Grover St
Omaha, NE 68106-3831
Phone
(402) 659-4346
Fax
(402) 551-3257
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2446 NE Primary
Physical Therapist 225100000X 03965 IA

Addresses

Primary practice location

5030 Grover St
Omaha, NE 68106-3831

Mailing address

5030 Grover St
Omaha, NE 68106-3831
Phone (402) 659-4346

Other identifiers 1

IdentifierTypeStateIssuer
10025229000MedicaidNE

Other names 1

  • Susan Elizabeth Lofgren Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060808000430 NE Practitioner - Physical Therapist in Private Practice 5092718205 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Siegmund Physical Therapy PCGroup PAC ID 1254460496, 11 clinicians

Practice addresses (Care Compare)

19111 Mason PLZ
Elkhorn, NE 68022-5659
Phone (402) 504-9797

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
03965IAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Siegmund Physical Therapy, PC Physical Therapist CurrentSince Mar 1, 2010 Accepting new patients
Physiotherapy Associates Inc Past Accepting new patients
Physiotherapy Associates Inc Past Accepting new patients

Locations

19111 Mason Plz
Elkhorn, NE 68022
Phone (402) 504-9797

5030 Grover St
Omaha, NE 68106
Phone (402) 551-0575

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266451200000",
    "number": "1740205103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5030 GROVER ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681063831",
            "telephone_number": "402-659-4346",
            "fax_number": "402-551-3257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 GROVER ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681063831",
            "telephone_number": "402-659-4346",
            "fax_number": "402-551-3257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGMUND",
        "first_name": "SUSAN",
        "middle_name": "ELIZABETH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2010-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "2446",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "03965",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025229000",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "LOFGREN",
            "middle_name": "ELIZABETH",
            "credential": "DPT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2010; 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.