Provider Demographics
NPI:1205832508
Name:BARTELS, MICHAEL D (PT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:D
Last Name:BARTELS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11336 S 96TH ST
Mailing Address - Street 2:SUITE 114
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-4209
Mailing Address - Country:US
Mailing Address - Phone:402-315-3603
Mailing Address - Fax:402-315-3604
Practice Address - Street 1:11336 S 96TH ST
Practice Address - Street 2:SUITE 114
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-4209
Practice Address - Country:US
Practice Address - Phone:402-315-3603
Practice Address - Fax:402-315-3604
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8472251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025656400Medicaid
NENA1131002Medicare PIN