Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Samuel Nissly

Individual provider Physical Therapist · NPI 1700620051

Samuel Nissly is registered under Physical Therapist in Private Practice in Grimes, Iowa. Qualified in 2024, 2 years ago. Practices with Athletico Ltd, a 2,186-clinician group and accepts Medicare assignment. Licensed in Iowa.

Years since qualifying
2
Licensed in
IA
In the registry since
2024
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Practice location Address checks out

241 SE Destination Dr Ste 200
Grimes, IA 50111-1249
Phone: (515) 986-5190
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 126470 (IA)

Record details

NPI number1700620051
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 21, 2024
Last updated in NPPESJune 21, 2024
Certification dateJune 21, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Athletico Ltd — 2186 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients23
Services billed 420 a service is one billed item, such as a visit, a test or a procedure
Average patient age71

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Colleagues at Athletico Ltd

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 2186 clinicians in the practice; 12 are shown here.

Other providers in Grimes