Douglas E. Brouillette, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

16805 Issued in NE

Practice address

8901 Indian Hills Dr
Suite 200
Omaha, NE 68114-4057

Phone

(402) 397-7057

Fax

(402) 397-6656

NPI assigned

Feb 21, 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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Methodist Fremont Health

  • Internal Medicine Physician
  • Fremont, NE
  • NPI 1235618216
  NPD
• Midwest Endoscopy Services LLC

  • Ambulatory Surgical Clinic/Center
  • Omaha, NE
  • NPI 1053385328
  NPD (past)

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260230400000",
    "number": "1013982370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 INDIAN HILLS DR",
            "address_2": "SUITE 200",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144057",
            "telephone_number": "402-397-7057",
            "fax_number": "402-397-6656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 INDIAN HILLS DR",
            "address_2": "SUITE 200",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144057",
            "telephone_number": "402-397-7057",
            "fax_number": "402-397-6656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUILLETTE",
        "first_name": "DOUGLAS",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2009-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NE",
            "license": "16805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47077295213",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025290600",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stacey Broski, OTD, OTR/L
• Alison Marie Bross, APRN
• Margaret Kay Bross, RN
• Rebecka Ann Brott, PLMHP, PCMSW
• Marin J Broucek, M.D.
• Jessika Broveak
• Michelle Kay Brovont, RN
• Elizabeth Sarah Brower, LMHP, BCBA
• Morgan Elizabeth Wittmeier Brower
• Austin Cole Browers

• Gastroenterology Physician in Omaha, NE
• Providers in Omaha, NE by specialty
• Gastroenterology Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.