GREGORY RYAN TOLLEFSEN (PA-C, ATC) – Physician Assistant, NPI 1801080734

GREGORY RYAN TOLLEFSEN (PA-C, ATC) is a healthcare provider. based in Kearney, Nebraska. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C, ATC. They hold a License No. 1644 (NE). The NPI Number for GREGORY RYAN TOLLEFSEN (PA-C, ATC) is 1801080734

Main info

Male
15 Years Of Experience
Accepts Medicare Assignment
Name
GREGORY RYAN TOLLEFSEN (PA-C, ATC)
NPI
1801080734
Phone
(308) 865-2570
Address
2810 W 35TH ST
Enumeration Date
4 September 2007
Last Update Date
12 October 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4025922055
Graduation Year
2011 (15 years ago)
PAC ID
2466612718
Group Practice PAC ID
6002898517
Professional Enrollment ID
I20120326000105
Address ID
NE681234303BE3503XWAYX302
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:18State licenses:1Digital endpointsOther names

1,397 PHYSICIAN ASSISTANT in NE

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Provider Addresses for GREGORY RYAN TOLLEFSEN (PA-C, ATC)

  • New West Sports Medicine & Orthopaedic Surgery, 2810, West 35th Street, Kearney, Buffalo County, Nebraska, 68845, United States

    SUITE 1

    KEARNEY, NE 688452909

    Phone: (308) 865-2570

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 22 Open Payments records for all available years, with a total value of $489.

Total Amount is formed as General ($489) + Research ($0) + Ownership ($0) = $489.

Last reported payment date: 2024-12-17 • Largest payer in this snapshot: Regeneron Healthcare Solutions, Inc. ($87).

Total Amount

$489

General + Research + Ownership

Payments

22

Total payment records

General Amount

$489

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-17

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-03-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120326000105IPhysician AssistantNETBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 68845)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6002898517View full group profile
NameSpecialtyState
A L L E R G Y/ I M M U N O L O G YNE
A L L E R G Y/ I M M U N O L O G YNE
-NE

Reviews

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Frequently asked questions

What unique ID ties claims to GREGORY RYAN TOLLEFSEN (PA-C, ATC)?
NPI 1801080734 is assigned to GREGORY RYAN TOLLEFSEN (PA-C, ATC) under the national enumeration system.
Is GREGORY RYAN TOLLEFSEN (PA-C, ATC)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does GREGORY RYAN TOLLEFSEN (PA-C, ATC) list a primary specialty?
If you are matching referrals, note Physician Assistant for GREGORY RYAN TOLLEFSEN (PA-C, ATC). Clinical services aligned with this taxonomy classification.
What location metadata exists for GREGORY RYAN TOLLEFSEN (PA-C, ATC)?
The page summarizes Kearney, Nebraska for GREGORY RYAN TOLLEFSEN (PA-C, ATC); expand the address list for detail.
Is GREGORY RYAN TOLLEFSEN (PA-C, ATC) a real provider?
This page reflects official NPPES data for NPI 1801080734. Always confirm identity and privileges with the practice and licensing boards.

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