Individual provider Active NPI

Amy Beyersdorf, PT

  • Physical Therapist
  • Omaha, NE
National Provider Identifier
1811073745
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1328 Issued in NE
Practice address
985450 Nebraska Med Ctr
Omaha, NE 68198-0001
Phone
(402) 559-8943
NPI assigned
Oct 31, 2006
Last updated
Sep 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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 1328 NE Primary

Addresses

Primary practice location

985450 Nebraska Med Ctr
Omaha, NE 68198-0001

Mailing address

985450 Nebraska Med Ctr
Omaha, NE 68198-0001
Phone (402) 559-8943

Other identifiers 1

IdentifierTypeStateIssuer
10025288900MedicaidNE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100422000634 NE Practitioner - Physical Therapist in Private Practice 8426185489 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1328NEMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Nebraska Board of Regents CurrentSince Feb 17, 2010 Accepting new patients
University of Nebraska Board of Regents CurrentSince Feb 17, 2010 Accepting new patients

Locations

444 S 44th St
Omaha, NE 68131
Phone (402) 559-3563

6902 Pine St
Omaha, NE 68106
Phone (402) 559-6418

985450 Nebraska Medical Ctr
Omaha, NE 68198
Phone (402) 559-6408

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1811073745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "985450 NEBRASKA MED CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681980001",
            "telephone_number": "402-559-8943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "985450 NEBRASKA MED CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681980001",
            "telephone_number": "402-559-8943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEYERSDORF",
        "first_name": "AMY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "1328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025288900",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.