Individual provider Active NPI

Troy D Bracker, M.D.

  • Family Medicine Physician
  • Omaha, NE
National Provider Identifier
1053369900
Registry record updated Jul 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
19921 Issued in NE
Practice address
5908 S 142ND St
Omaha, NE 68137-2800
Phone
(402) 354-1900
Fax
(402) 354-1910
NPI assigned
May 4, 2006
Last updated
Jul 15, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 19921 NE Primary
Family Medicine Physician 207Q00000X 47278 CO

Addresses

Primary practice location

5908 S 142ND St
Omaha, NE 68137-2800

Mailing address

PO Box 3755
Omaha, NE 68103-0755
Phone (402) 354-2100

Other identifiers 6

IdentifierTypeStateIssuer
10024994800MedicaidNE
1053369900MedicaidIA
47068731741MedicaidNE
47068731734MedicaidNE
47068731749MedicaidNE
47068731706MedicaidNE

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
I20110511000870 NE Practitioner - Family Practice 4284721713 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Nebraska College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Clinic IncGroup PAC ID 4880506062, 557 clinicians

Practice addresses (Care Compare)

10060 Regency Cir
Omaha, NE 68114-3732
Phone (402) 354-1570

4932 S 202ND Ave
MPC North Streams
Omaha, NE 68135-3927
Phone (402) 815-7500

717 N 190TH PLZ
Suite 1100
Elkhorn, NE 68022-3917
Phone (402) 815-1700

8901 W Dodge Rd
Omaha, NE 68114-3327
Phone (402) 390-1200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
47278COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fremont Health Clinic Family Medicine Current Accepting new patients
Physicians Clinic Inc Family Medicine CurrentSince May 31, 2011 Accepting new patients
Neurology Consultants of Nebraska PC Past Accepting new patients

Locations

810 N 22nd St
#H
Blair, NE 68008
Phone (402) 426-2182

2540 N Healthy Way
Fremont, NE 68025
Phone (402) 721-3133

450 E 23rd St
Fremont, NE 68025
Phone (402) 721-1610

10060 Regency Cir
Omaha, NE 68114
Phone (402) 354-1405

5908 S 142nd St
Omaha, NE 68137
Phone (402) 354-1900

101 E Centennial Rd
Papillion, NE 68046
Phone (402) 354-7750

Interoperability endpoints

  • Direct secure messaging: troy.bracker@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468540800000",
    "number": "1053369900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3755",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681030755",
            "telephone_number": "402-354-2100",
            "fax_number": "402-354-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5908 S 142ND ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681372800",
            "telephone_number": "402-354-1900",
            "fax_number": "402-354-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACKER",
        "first_name": "TROY",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2016-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "19921",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "47278",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10024994800",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053369900",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47068731741",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47068731734",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47068731749",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47068731706",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.