Individual provider Active NPI

Jacob Bickel, DPT

  • Physical Therapist
  • Fort Wayne, IN
National Provider Identifier
1790476646
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
4025 Sage Bluff Xing
Fort Wayne, IN 46804-2365
Phone
(260) 497-7191
NPI assigned
May 19, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2023

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 Primary

Addresses

Primary practice location

4025 Sage Bluff Xing
Fort Wayne, IN 46804-2365

Mailing address

12844 Coldwater Rd Ste B
Fort Wayne, IN 46845-8833
Phone (260) 497-7191

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230612002520 IN Practitioner - Physical Therapist in Private Practice 0941667638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Steppin' Up Physical Therapy, Inc.Group PAC ID 3476516071, 21 clinicians

Practice addresses (Care Compare)

4025 Sage Bluff Xing
Fort Wayne, IN 46804-2365
Phone (260) 497-7191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Steppin Up Physical Therapy, Inc. Physical Therapist CurrentSince May 9, 2023 Accepting new patients
Steppin Up Physical Therapy, Inc. CurrentSince May 9, 2023 Accepting new patients

Locations

3805 S Calhoun St
Fort Wayne, IN 46807
Phone 2604977191201

4025 Sage Bluff Xing
Fort Wayne, IN 46804
Phone (260) 443-3044

12844 Coldwater Rd
Ste B
Fort Wayne, IN 46845

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": "1684454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1790476646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12844 COLDWATER RD STE B",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468458833",
            "telephone_number": "260-497-7191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4025 SAGE BLUFF XING",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468042365",
            "telephone_number": "260-497-7191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BICKEL",
        "first_name": "JACOB",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-19",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2023; 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.