Individual provider Active NPI

Alicia L. Wachal, APRN

  • Nurse Practitioner
  • Elkhorn, NE
National Provider Identifier
1073891628
Registry record updated Feb 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11278 Issued in NE
Practice address
717 N 190TH PLZ
Ste. 1100
Elkhorn, NE 68022-3913
Phone
(402) 815-1700
Fax
(402) 815-1959
NPI assigned
Aug 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11278 NE Primary

Addresses

Primary practice location

717 N 190TH PLZ
Ste. 1100
Elkhorn, NE 68022-3913

Mailing address

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

Other identifiers 4

IdentifierTypeStateIssuer
47068731799MedicaidNE
10026301600MedicaidNE
10026480100MedicaidNE
1073891628MedicaidIA

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110811000791 NE Practitioner - Nurse Practitioner 7719156595 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
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

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

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11278NEMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nebraska Methodist Hospital Current Accepting new patients
Physicians Clinic Inc Nurse Practitioner CurrentSince Jul 27, 2011 Accepting new patients
G2 Aesthetics LLC Nurse Practitioner Current Accepting new patients

Locations

717 N 190th Plz
Ste 1100
Elkhorn, NE 68022
Phone (402) 815-1700

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

8601 W Dodge Rd
Ste 216
Omaha, NE 68114
Phone (402) 354-4822

Interoperability endpoints

  • Direct secure messaging: alicia.wachal@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 1

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": "1312156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771200000000",
    "number": "1073891628",
    "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": "717 N 190TH PLZ",
            "address_2": "STE. 1100",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680223913",
            "telephone_number": "402-815-1700",
            "fax_number": "402-815-1959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WACHAL",
        "first_name": "ALICIA",
        "middle_name": "L.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-01",
        "last_updated": "2026-02-16",
        "certification_date": "2026-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NE",
            "license": "11278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47068731799",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026301600",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026480100",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073891628",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhorn, NE

Sources for this page

Verify at the official NPI Registry.