Individual provider Active NPI

Michael G Dawson, MD

  • Pediatrics Physician
  • Boys Town, NE
National Provider Identifier
1043472632
Registry record updated Feb 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
26040 Issued in NE
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

Updated by the provider on Feb 19, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
5915NEMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Father Flanagan'S Boys' Home Pediatrics CurrentSince Aug 1, 2011 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.

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

Verify at the official NPI Registry.