Individual provider Active NPI

Donald Patrick Ostdiek, DPT

  • Physical Therapist
  • Omaha, NE
National Provider Identifier
1740262963
Registry record updated Mar 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1971 Issued in NE
Practice address
3407 S 84TH St
Omaha, NE 68124-3325
Phone
(402) 614-8042
Fax
(402) 614-8043
NPI assigned
Nov 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2011

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 1971 NE Primary

Addresses

Primary practice location

3407 S 84TH St
Omaha, NE 68124-3325

Mailing address

3407 S 84TH St
Omaha, NE 68124-3325
Phone (402) 614-8042

Other identifiers 3

IdentifierTypeStateIssuer
10025878400MedicaidNE
P00892273OtherNERAILROAD MEDICARE
39841OtherNEBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080930000296 NE Practitioner - Physical Therapist in Private Practice 4981771128 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10807 Elm St
Omaha, NE 68144-4819
Phone (402) 614-8042

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1971NEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Works Inc Physical Therapist CurrentSince Sep 23, 2011 Accepting new patients
Community Rehab LLC Physical Therapist Past Accepting new patients

Locations

3407 S 84th St
Omaha, NE 68124
Phone (402) 614-8042

10807 Elm St
Omaha, NE 68144
Phone (402) 614-8042

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301270400000",
    "number": "1740262963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3407 S 84TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681243325",
            "telephone_number": "402-614-8042",
            "fax_number": "402-614-8043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3407 S 84TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681243325",
            "telephone_number": "402-614-8042",
            "fax_number": "402-614-8043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSTDIEK",
        "first_name": "DONALD",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2011-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "1971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025878400",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00892273",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "39841",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Mar 28, 2011; 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.