Individual provider Active NPI

Katerina N. Goldman, PA-C

  • Medical Physician Assistant
  • Omaha, NE
National Provider Identifier
1013192368
Registry record updated Dec 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
8303 Dodge St
Suite # 304
Omaha, NE 68114-4108
Phone
(402) 354-5048
Fax
(402) 354-2585
NPI assigned
Jan 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

8303 Dodge St
Suite # 304
Omaha, NE 68114-4108

Mailing address

PO Box 10190
Virginia Beach, VA 23450-0190
Phone (800) 477-5240

Other identifiers 1

IdentifierTypeStateIssuer
100250444-00MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080711000527 NE Practitioner - Physician Assistant 3870665516 Reassigns benefits to 2 organizations
I20240402003404 IA Practitioner - Physician Assistant 3870665516 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nebraska Methodist HospitalGroup PAC ID 6901707447, 132 clinicians

Practice addresses (Care Compare)

8303 Dodge St
Omaha, NE 68114-4108

8303 W Dodge St
Omaha, NE 68114-4108
Phone (402) 354-9400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Fremont Health CurrentSince Feb 28, 2024 Accepting new patients
Nebraska Methodist Hospital Physician Assistant CurrentSince Apr 7, 2008 Accepting new patients

Locations

201 Ridge St
Ste 312
Council Bluffs, IA 51503
Phone (402) 815-1970

1 Edmundson Pl
Ste 100
Council Bluffs, IA 51503
Phone (712) 396-4429

207 S Engdahl Ave
Oakland, NE 68045
Phone (402) 685-5683

825 S 169th St
Omaha, NE 68118
Phone (402) 354-3370

8303 W Dodge Rd
Omaha, NE 68114
Phone (402) 354-4000

8303 Dodge St
Ste 304
Omaha, NE 68114
Phone (402) 354-4104

Interoperability endpoints

  • Direct secure messaging: katerina.goldman@direct.nmhs.org

Organizations & group practices 2

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 1

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": "1199664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386892800000",
    "number": "1013192368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10190",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234500190",
            "telephone_number": "800-477-5240",
            "fax_number": "757-463-6572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8303 DODGE ST",
            "address_2": "SUITE # 304",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144108",
            "telephone_number": "402-354-5048",
            "fax_number": "402-354-2585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "KATERINA",
        "middle_name": "N.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-07",
        "last_updated": "2013-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100250444-00",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.