Individual provider Active NPI

Jacob Daniel Hoermann, PT, DPT

  • Physical Therapist
  • Fredericksburg, TX
National Provider Identifier
1811536006
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3124839 Issued in TX
Practice address
1316 S State Highway 16
Fredericksburg, TX 78624-5058
Phone
(830) 997-2001
Fax
(830) 997-0781
NPI assigned
Jan 6, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

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 3124839 TX Primary

Addresses

Primary practice location

1316 S State Highway 16
Fredericksburg, TX 78624-5058

Mailing address

117 Edgewood Dr
Fredericksburg, TX 78624-2935
Phone (830) 889-0050

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200508000375 TX Practitioner - Physical Therapist in Private Practice 2365873221 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cole Physical Therapy IncGroup PAC ID 4183670441, 16 clinicians

Practice addresses (Care Compare)

1316 S State Hwy 16
Sports Medicine and Physical Therapy
Fredericksburg, TX 78624-5058
Phone (830) 997-2001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cole Physical Therapy Inc Physical Therapist CurrentSince Jan 31, 2020 Accepting new patients
Revive Physical Therapy Inc Past Accepting new patients

Locations

1316 S State Highway 16
Fredericksburg, TX 78624
Phone (830) 798-3497

21122 State Highway 71 W
Unit B
Spicewood, TX 78669
Phone (512) 264-9981

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": "1578268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1811536006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 EDGEWOOD DR",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786242935",
            "telephone_number": "830-889-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 S STATE HIGHWAY 16",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786245058",
            "telephone_number": "830-997-2001",
            "fax_number": "830-997-0781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOERMANN",
        "first_name": "JACOB",
        "middle_name": "DANIEL",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-06",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "3124839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2020; 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.