Individual provider Active NPI

Bryce Allen Rolenc, PT, DPT

  • Physical Therapist
  • Crete, NE
National Provider Identifier
1750940839
Registry record updated Aug 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
NE3950 Issued in NE
Practice address
1105 E Highway 33
Crete, NE 68333-5075
Phone
(402) 826-2255
Fax
(402) 826-2288
NPI assigned
Jun 11, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2020

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 NE3950 NE Primary

Addresses

Primary practice location

1105 E Highway 33
Crete, NE 68333-5075

Mailing address

1550 S Coddington Ave Ste C
Lincoln, NE 68522-4402
Phone (402) 423-0303

Other practice location 1

1550 S Coddington Ave Ste C
Lincoln, NE 68522-4402
Phone (402) 423-0303

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190718002787 NE Practitioner - Physical Therapist in Private Practice 9638404213 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Nebraska College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peak Physical Therapy and Sports Performance LLCGroup PAC ID 1052444072, 2 clinicians

Practice addresses (Care Compare)

8901 Andermatt Dr
Suite 105
Lincoln, NE 68526-6032

8901 Andermatt Dr
Suite 105
Lincoln, NE 68526-9756
Phone (402) 423-7325

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NE3950NEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Crete Physical Therapy, LLC Physical Therapist CurrentSince Aug 1, 2020 Accepting new patients
Coddington Physical Therapy, LLC Physical Therapist CurrentSince Aug 1, 2020 Accepting new patients

Locations

830 E 1st St
Crete, NE 68333
Phone (402) 826-2255

1550 S Coddington Ave
Ste C
Lincoln, NE 68522
Phone (402) 423-0303

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": "1560211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598486400000",
    "number": "1750940839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 S CODDINGTON AVE STE C",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685224402",
            "telephone_number": "402-423-0303",
            "fax_number": "402-423-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 E HIGHWAY 33",
            "city": "CRETE",
            "state": "NE",
            "postal_code": "683335075",
            "telephone_number": "402-826-2255",
            "fax_number": "402-826-2288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1550 S Coddington Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Lincoln",
            "state": "NE",
            "postal_code": "685224402",
            "country_code": "US",
            "telephone_number": "402-423-0303",
            "fax_number": "402-423-0202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROLENC",
        "first_name": "BRYCE",
        "middle_name": "ALLEN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-11",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "NE3950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crete, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2020; 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.