Individual provider Active NPI

Gabriel Jefferson, PA-C

  • Physician Assistant
  • Lincoln, NE
National Provider Identifier
1003221029
Registry record updated Jul 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
5000 N 26TH St
Suite 100
Lincoln, NE 68521-4749
Phone
(402) 435-5300
NPI assigned
Jun 28, 2014
Last updated
Jul 16, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

5000 N 26TH St
Suite 100
Lincoln, NE 68521-4749

Mailing address

2222 S 16TH St
Ste 400a
Lincoln, NE 68502-3785
Phone (402) 483-8590

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140723000241 NE Practitioner - Physician Assistant 9638395940 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bryan Physician NetworkGroup PAC ID 7315915873, 236 clinicians

Practice addresses (Care Compare)

2300 S 16TH St
Bryan Medical Center
Lincoln, NE 68502-3704
Phone (402) 481-1111

5901 N 27TH St
Lincoln, NE 68521-4752

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bryan Physician Network CurrentSince Jul 1, 2018 Accepting new patients

Locations

2222 S 16th St
Ste 400A
Lincoln, NE 68502
Phone (402) 475-8877

2300 S 16th St
Lincoln, NE 68502
Phone (402) 434-6042

5000 N 26th St
Ste 100
Lincoln, NE 68521
Phone (402) 435-5300

5000 N 26th St
Ste 200
Lincoln, NE 68521
Phone (402) 475-6656

5901 N 27th St
Ste 102
Lincoln, NE 68521
Phone (402) 481-6343

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1403913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531699200000",
    "number": "1003221029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 S 16TH ST",
            "address_2": "STE 400A",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685023785",
            "telephone_number": "402-483-8590",
            "fax_number": "402-483-8599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 N 26TH ST",
            "address_2": "SUITE 100",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685214749",
            "telephone_number": "402-435-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "GABRIEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-28",
        "last_updated": "2018-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.