FRED ANTCZAK (NPI# 1649573676) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649573676 |
| Entity Type | Individual |
| Full Name | FRED ANTCZAK |
| Practice Address |
17931 Pierce Plz Omaha NE 68130-2654 |
| Practice Telephone | 4029331393 |
| Practice Fax Number | 4029331899 |
| Mailing Telephone | 4029331393 |
| Mailing Fax Number | 4029331899 |
| Enumeration Date | 2010-12-14 |
| Last Update Date | 2010-12-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Z00000X | Orthotist | 2255 | VA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 225000000X | Orthotic Fitter | 2255 | VA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 224L00000X | Pedorthist | 0675 | VA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
17931 PIERCE PLZ |
| City | OMAHA |
| State | NE |
| Zip Code | 68130-2654 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619066800 | Nichlos Jason Crom | Chiropractor | 17931 Pierce Plz, Omaha, NE 68130-2654 | 2006-10-12 |
| 1215227780 | Thomas Masters | Prosthetist | 17931 Pierce Plz, Omaha, NE 68130-2654 | 2011-04-18 |
| 1770767915 | Spring Ridge Chiropractic and Acupuncture LLC | Chiropractor | 17931 Pierce Plz, Omaha, NE 68130-2654 | 2007-12-24 |
| 1366501272 | Nicholas Ryan Wisniewski | Chiropractor | 17931 Pierce Plz, Omaha, NE 68130-2654 | 2006-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861998270 | Samantha June Curto | Nurse Practitioner | 17021 Lakeside Drive, Suite 200, Omaha, NE 68130 | 2018-04-04 |
| 1780196451 | Heritage Oncare Home Health LLC | Home Health | 16934 Frances St Ste 200, Omaha, NE 68130 | 2017-11-02 |
| 1497281745 | Dental Professionals of Nebraska, PC | Dentist | 17810 Pierce Plaza, Suite 100, Omaha, NE 68130 | 2017-05-05 |
| 1891166492 | Stephanie Tupper | Speech-Language Pathologist | 16338 Oak Circle, Omaha, NE 68130 | 2015-10-08 |
| 1194036723 | Anthony John Macdissi | Internal Medicine | 16901 Lakeside Hills Court, Attn: Hospital Medicine Dept., Omaha, NE 68130 | 2010-06-29 |
| 1568613305 | Kelly Marie Barkmeier | Occupational Therapist | 1906 South 196th Street, Omaha, NE 68130 | 2008-10-09 |
| 1306009758 | Melissa Sue Loseke | Family Medicine | 17021 Lakeside Hills Plz #200, Omaha, NE 68130 | 2008-07-07 |
| 1477724417 | Denise L. Pollard | Nurse Practitioner | 17525 Gold Plaza Ste 116, Omaha, NE 68130 | 2008-03-18 |
| 1508053943 | Omaha Family Medicine, P.C. | Family Medicine | 17841 Pierce Plz, Omaha, NE 68130 | 2007-10-01 |
| 1669672523 | Jennifer L Liu | Family Medicine | 16909 Lakeside Hills, Ste 300, Omaha, NE 68130 | 2007-07-19 |
| Find all providers in zip 68130 | ||||
| Taxonomy Code | 222Z00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Orthotist |
| A health care professional who is specifically educated and trained to manage comprehensive orthotic patient care, including musculoskeletal and neuromuscular anomalies resulting from injuries or disease processes involving the lower extremity, upper extremity or spinal segment/s and positional deformation of the cranium. Orthotists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598220873 | George Ross Gerrard | Orthotist | 12135 W Center Rd, Omaha, NE 68144-3955 | 2019-01-31 |
| 1215460258 | Raymond Richard Lines | Orthotist | 4101 Woolworth Ave, Omaha, NE 68105-1850 | 2017-04-06 |
| 1720220809 | Adam Jacobsen | Orthotist | 4101 Woolworth Ave, Room 7505, Omaha, NE 68105-1850 | 2009-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972005056 | Rachel Beaudette | Orthotist | 223 E 14th St Ste 5, Hastings, NE 68901-3240 | 2018-03-05 |
| 1235375973 | Raghvendra Prajapati | Orthotist | 223 E 14th St, Suite 5, Hastings, NE 68901-3200 | 2008-12-31 |
| 1841373016 | Eric J Bjorkman | Orthotist | 2130 S 17th St, Suite 200, Lincoln, NE 68502-3750 | 2006-10-23 |
Please comment or provide details below to improve the information on FRED ANTCZAK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.