Individual provider Active NPI

Robert R Shaffer, M.D.

  • Anesthesiology Physician
  • Kearney, NE
National Provider Identifier
1013120492
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
23005 Issued in NE
Practice address
115 E 52ND St
Kearney, NE 68847
Phone
(308) 234-2581
Fax
(308) 236-7089
NPI assigned
May 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 23005 NE Primary

Addresses

Primary practice location

115 E 52ND St
Kearney, NE 68847

Mailing address

PO Box 963
Kearney, NE 68848-0963
Phone (308) 236-5506

Other identifiers 1

IdentifierTypeStateIssuer
23005OtherNEPHYSICIAN

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070713000079 NE Practitioner - Anesthesiology 6608976121 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Nebraska College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7500 Mercy Rd
Omaha, NE 68124-2319
Phone (402) 717-4866

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
23005NEMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CHI Health Clinic Physician Enterprise-Anesthesia LLC Anesthesiology CurrentSince May 1, 2019 Accepting new patients
Doctors Anesthesia Group, P.C. Anesthesiology Past Accepting new patients
CHI Health Clinic Physician Enterprise-Anesthesia LLC Anesthesiology Past Accepting new patients
Alegent Creighton Clinic PastSince Jul 1, 2020 Accepting new patients

Locations

2620 W Faidley Ave
Grand Island, NE 68803
Phone (308) 382-6856

10 E 31st St
Kearney, NE 68847
Phone (308) 234-5520

7500 Mercy Rd
Ste 1355
Omaha, NE 68124
Phone (402) 717-4866

Organizations & group practices 4

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

Hospital & facility affiliations 2

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": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013120492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 963",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688480963",
            "telephone_number": "308-236-5506",
            "fax_number": "308-236-7089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E 52ND ST",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "68847",
            "telephone_number": "308-234-2581",
            "fax_number": "308-236-7089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFFER",
        "first_name": "ROBERT",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NE",
            "license": "23005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN",
            "identifier": "23005",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearney, NE

Sources for this page

Verify at the official NPI Registry.