Individual provider Active NPI

Ola A. Simonsson, PT, OCS, MTC

  • Physical Therapist
  • Greeley, CO
National Provider Identifier
1871690032
Registry record updated Jun 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4161 Issued in CO
Practice address
5881 W 16TH St
Greeley, CO 80634-2910
Phone
(970) 313-2775
Fax
(970) 313-2777
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 4161 CO
Physical Therapist 225100000X 4161 CO Primary

Addresses

Primary practice location

5881 W 16TH St
Greeley, CO 80634-2910

Mailing address

5881 W 16TH St
Greeley, CO 80634-2910
Phone (970) 313-2775

Other identifiers 2

IdentifierTypeStateIssuer
63333821MedicaidCO
P00944902OtherCOMEDICARE RAILROAD CARRIER PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080501000065 CO Practitioner - Physical Therapist in Private Practice 9931288081 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

6767 29TH St
Greeley, CO 80634-5474
Phone (970) 224-3636

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4161COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Jul 11, 2010 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jul 11, 2010 Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

1900 16th St
Greeley, CO 80631
Phone (970) 350-2438

6767 29th St
Fl 1
Greeley, CO 80634
Phone (970) 652-2477

6767 29th St
Greeley, CO 80634
Phone (970) 652-2000

5881 W 16th St
Greeley, CO 80634
Phone (970) 313-2700

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370995200000",
    "number": "1871690032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5881 W 16TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806342910",
            "telephone_number": "970-313-2775",
            "fax_number": "970-313-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5881 W 16TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806342910",
            "telephone_number": "970-313-2775",
            "fax_number": "970-313-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONSSON",
        "first_name": "OLA",
        "middle_name": "A.",
        "name_prefix": "Mr.",
        "credential": "PT, OCS, MTC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2013-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CO",
            "license": "4161",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "4161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "63333821",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD CARRIER PTAN",
            "identifier": "P00944902",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2013; 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.