Individual provider Active NPI

Brian Lee Hofsommer

  • Marriage & Family Therapist
  • Omaha, NE
National Provider Identifier
1063727360
Registry record updated Mar 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1343 Issued in NE
Practice address
9300 Underwood Ave
Suite 240
Omaha, NE 68114-2400
Phone
(402) 708-2348
Fax
(402) 403-3759
NPI assigned
Aug 11, 2010
Last updated
Mar 5, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 9610 NE
Marriage & Family Therapist 106H00000X 1343 NE Primary

Addresses

Primary practice location

9300 Underwood Ave
Suite 240
Omaha, NE 68114-2400

Mailing address

1506 N 58TH St
Omaha, NE 68104-4820
Phone (402) 708-2348

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240510001043 NE Practitioner - Mental Health Counselor 4183065972 Practice locations: Omaha, NE

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9300 Underwood Ave
Suite 240
Omaha, NE 68114-2400

9300 Underwood Ave
Suite 240
Omaha, NE 68114-2685
Phone (402) 708-2348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9610NEMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1281484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425513600000",
    "number": "1063727360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1506 N 58TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681044820",
            "telephone_number": "402-708-2348",
            "fax_number": "402-403-3759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 UNDERWOOD AVE",
            "address_2": "SUITE 240",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681142400",
            "telephone_number": "402-708-2348",
            "fax_number": "402-403-3759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFSOMMER",
        "first_name": "BRIAN",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-11",
        "last_updated": "2015-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NE",
            "license": "9610",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NE",
            "license": "1343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.