Gregory Ryan Tollefsen, PA-C, ATC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1644 Issued in NE

Practice address

2810 W 35TH St
Suite 1
Kearney, NE 68845-2909

Phone

(308) 865-2570

NPI assigned

Sep 4, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• The Asthma & Allergy Center PC

  • Allergy & Immunology Physician
  • Bellevue, NE
  • NPI 1730151721
  Medicare reassignment

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

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476230400000",
    "number": "1801080734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 W 35TH ST",
            "address_2": "SUITE 1",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688452909",
            "telephone_number": "308-865-2570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 W 35TH ST",
            "address_2": "SUITE 1",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688452909",
            "telephone_number": "308-865-2570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLLEFSEN",
        "first_name": "GREGORY",
        "middle_name": "RYAN",
        "credential": "PA-C, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-04",
        "last_updated": "2016-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Time for Baby
• Lori M Tinkham
• TJ Four Family
• TKC Optical, Inc
• Megan Toahty
• Tooth Fairy PC
• Nagib T Toubia, MD
• Pamela S Trantham, PLMHP
• Trenton L. Talbitzer LLC
• Taryn Elizabeth Trosper, PA-C

• Physician Assistant in Kearney, NE
• Providers in Kearney, NE by specialty
• Physician Assistant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.