Individual provider Active NPI

Brent Jonathan Tierney, M.D.

  • Gynecologic Oncology Physician
  • Omaha, NE
National Provider Identifier
1033316294
Registry record updated Nov 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
27892 Issued in NE
Practice address
8303 Dodge St
Suite 300
Omaha, NE 68114-4108
Phone
(402) 354-5250
Fax
(402) 354-3437
NPI assigned
Jun 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 5627 NE
Gynecologic Oncology Physician 207VX0201X 35.097164 OH
Gynecologic Oncology Physician 207VX0201X 27892 NE Primary

Addresses

Primary practice location

8303 Dodge St
Suite 300
Omaha, NE 68114-4108

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
100250445-00MedicaidNE
1033316294MedicaidIA
100264208-00MedicaidNE

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
I20140626001980 NE Practitioner - Gynecological OncologyPractitioner - Obstetrics/Gynecology 4385816263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gynecological OncologyAlso: Obstetrics/Gynecology
Education
Creighton University School of Medicine, 2007
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)

707 N 190TH Plaza
Elkhorn, NE 68022-3974
Phone (402) 815-4000

717 N 190TH Plaza
Suite 2400
Elkhorn, NE 68022-3974
Phone (402) 815-1901

8303 Dodge St
Omaha, NE 68114-4108

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

Hospital & facility affiliations

  • The Nebraska Methodist Hospital Hospital, Omaha, NE, CCN 280040
  • Methodist Jennie Edmundson Hospital, Council Bluffs, IA, CCN 160047

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of the uterus29

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5627NEMDObstetrics & Gynecology Physician
35.097164OHMDGynecologic Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nebraska Methodist Hospital Obstetrics & Gynecology CurrentSince Jul 31, 2014 Accepting new patients
Nebraska Methodist Hospital Past Accepting new patients
Nebraska Methodist Hospital Past Accepting new patients

Locations

717 N 190th Plz
Ste 2100
Elkhorn, NE 68022
Phone (402) 354-5048

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

8303 Dodge St
Ste 300
Omaha, NE 68114
Phone (402) 354-5250

Interoperability endpoints

  • Direct secure messaging: brent.tierney@direct.nmhs.org

Organizations & group practices 3

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": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415145600000",
    "number": "1033316294",
    "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 300",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144108",
            "telephone_number": "402-354-5250",
            "fax_number": "402-354-3437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIERNEY",
        "first_name": "BRENT",
        "middle_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-29",
        "last_updated": "2014-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NE",
            "license": "5627",
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "OH",
            "license": "35.097164",
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "NE",
            "license": "27892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100250445-00",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033316294",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100264208-00",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.