Active NPI
Michael G Dawson, MD
- Pediatrics Physician
- Boys Town, NE
National Provider Identifier
1043472632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 26040
- Practice address
- 14080 Hospital Rd
Boys Town, NE 68010-7513 - Phone
- (402) 778-6900
- Fax
- (402) 778-6917
- NPI assigned
- Jun 26, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 5915 | NE | |
| Pediatrics Physician | 208000000X | 26040 | NE | Primary |
Addresses
Primary practice location
14080 Hospital Rd
Boys Town, NE 68010-7513
Mailing address
555 N 30TH St
Omaha, NE 68131-2136
Phone (402) 280-8100
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110819000388 | NE | Practitioner - Pediatric Medicine | 0941470405 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5915 | NE | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Father Flanagan'S Boys' Home | Pediatrics | Current | Accepting new patients |
| Father Flanagan'S Boys Home | Past | Accepting new patients |
Locations
14080 Boys Town Hospital Rd
Boys Town, NE 68010
Phone (402) 778-6900
6715 S 180th St
Omaha, NE 68135
Phone (531) 355-2300
555 N 30th St
Omaha, NE 68131
Phone (402) 280-8100
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.
-
- Psychologist
- Boys Town, NE
- NPI 1265405419
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361232000000",
"number": "1043472632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "555 N 30TH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681312136",
"telephone_number": "402-280-8100",
"fax_number": "402-280-8103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14080 HOSPITAL RD",
"city": "BOYS TOWN",
"state": "NE",
"postal_code": "680107513",
"telephone_number": "402-778-6900",
"fax_number": "402-778-6917"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAWSON",
"first_name": "MICHAEL",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-26",
"last_updated": "2013-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NE",
"license": "5915",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NE",
"license": "26040",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boys Town, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.