Jose Renante Amado Combalecer, RPT
Individual provider Active NPI Physical Therapist · Bennington, NE
NPI 1801024534 · NPPES record last updated Jul 1, 2009
Key facts
- NPI
- 1801024534
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 1367 (NE)
- Practice address
- 15362 Mormon St
Bennington, NE 68007-1473 - Phone
- (402) 445-4024
- Fax
- (402) 445-4024
- NPI assigned
- Jul 1, 2009
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Choice Rehabilitation LLC
Practice addresses (Care Compare)
6803 N 68TH PLZ
Choice Rehab Agency
Omaha, NE 68152-2177
Phone (314) 275-9000
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NE
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240717001038 | NE | Practitioner - Physical Therapist in Private Practice | 3274722483 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1367 | NE | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Select Rehabilitation, LLC | Physical Therapist | Current |
Accepting new patients |
| Comper Care Rehab Inc | Past |
Accepting new patients | |
| Pando Geriatric Counseling, PC | Past | Accepting new patients |
Locations
5601 S 84th St
Lincoln, NE 68516
Phone (402) 480-0250
6991 S 178th Plz
Omaha, NE 68136
Phone (402) 819-0669
4801 N 52nd St
Omaha, NE 68104
Phone (402) 557-6860
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1367 | NE | Yes |
Addresses
Primary practice location
15362 Mormon St
Bennington, NE 68007-1473
Mailing address
15362 Mormon St
Bennington, NE 68007-1473
Phone (402) 445-4024
Other providers in Bennington, NE
- Alasia Clark
- Martina A Clarke-Davis
- Chelsea Clarke
- Zaylynn Symone Cobbs
- Cristine Codr
- Venus Reales Combalecer
- Isabelle Marie Comfort
- Lassoure Sosthene Compaore
- Clement Coovi
- Jackson Creek
All providers in Bennington, NE · Physical Therapist in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 1, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.