Alexander Nathan Bongers, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

306179 Issued in CA

Practice address

87 Fenton St Ste 106
Livermore, CA 94550-4159

Phone

(925) 373-9394

NPI assigned

Jun 5, 2024

Last updated

Aug 28, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Blue Stone Therapy Inc.

  • Physical Medicine & Rehabilitation Physician
  • Urbandale, IA
  • NPI 1932797297

  MN

  Medicare reassignment

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

{
    "created_epoch": "1717545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1790526424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12447 150TH ST E",
            "city": "NERSTRAND",
            "state": "MN",
            "postal_code": "550532233",
            "telephone_number": "507-649-7832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 FENTON ST STE 106",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945504159",
            "telephone_number": "925-373-9394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONGERS",
        "first_name": "ALEXANDER",
        "middle_name": "NATHAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-05",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "16792-24",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "306179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaineen Paula Bloss, D.C.
• Audrey Boe
• Jordan Boehler, LCSW
• Jade Elizabeth Ayres Bohl, PPS
• Aditi Reddy Bommireddy, MD
• Samantha Bonilla, MSW
• Ceceli Bonitto, AUD
• Lesli Michelle Borrelli
• Cheryl Joy Bowers, RN, CNS
• Victoria Bowers

• Physical Therapist in Livermore, CA
• Providers in Livermore, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; 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.