Robert G Penn, M.D.

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

13129 Issued in NE

Practice address

8111 Dodge St
Suite 363
Omaha, NE 68114-4129

Phone

(402) 354-8155

Fax

(402) 354-8159

NPI assigned

Jul 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Specialty

Infectious Disease

Education

University of Nebraska College of Medicine, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Infectious Diseases Associates PCGroup PAC ID 5597663369, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Nebraska Methodist Hospital Hospital, Omaha, NE, CCN 280040

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/49ec4064-7609-4f62-b5e6-20a05e00549b/

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.

• Infectious Diseases Associates PC

  • Infectious Disease Physician
  • Omaha, NE
  • NPI 1164448510
  Medicare reassignment Care Compare group NPD

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

• Nebraska Methodist Hospital

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1427147883
  Care Compare affiliation

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386892800000",
    "number": "1013937374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8111 DODGE ST",
            "address_2": "SUITE 363",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144129",
            "telephone_number": "402-354-8155",
            "fax_number": "402-354-8159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8111 DODGE ST",
            "address_2": "SUITE 363",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144129",
            "telephone_number": "402-354-8155",
            "fax_number": "402-354-8159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENN",
        "first_name": "ROBERT",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2013-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NE",
            "license": "13129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0923557",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202111902",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01565",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ceola Penn
• Darrius Penn
• Erica Erica Penn
• Malik Penn
• Reneasha Penn
• Shane Dexter Penna
• Patricia Ellen Penne, PHARMD
• Sharon Penne, OTRL
• Elizabeth Penner, M.D.
• Susan Kay Penner, PHYSICAL THERAPIST

• Infectious Disease Physician in Omaha, NE
• Providers in Omaha, NE by specialty
• Infectious Disease Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.