Individual provider Active NPI

Ethan Clay Schneider, MD

  • Hospitalist Physician
  • Council Bluffs, IA
National Provider Identifier
1083177224
Registry record updated Jul 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
MD-51235 Issued in IA
Practice address
933 E. Pierce St.
Council Bluffs, IA 51503-4626
Phone
(712) 396-4360
Fax
(712) 396-7069
NPI assigned
Apr 12, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2023

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 77345 WI
Hospitalist Physician 208M00000X MD-51235 IA Primary

Addresses

Primary practice location

933 E. Pierce St.
Council Bluffs, IA 51503-4626

Mailing address

933 E. Pierce St.
Council Bluffs, IA 51503-4626
Phone (712) 396-4360

Other practice location 1

7400 W State St Apt 220
Wauwatosa, WI 53213-2725
Phone (402) 340-6764

Other practice location 2

1319 Leavenworth St
Omaha, NE 68102-3215
Phone (402) 552-3222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, WI, IA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20220511000674 NE Practitioner - Family Practice 4385972124 Reassigns benefits to 1 organization
I20220921002504 WI Practitioner - HospitalistPractitioner - Family Practice 4385972124 Reassigns benefits to 1 organization
I20230719004020 IA Practitioner - Hospitalist 4385972124 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
University of Nebraska College of Medicine, 2019
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)

933 E Pierce St
Methodist Jennie Edmundson
Council Bluffs, IA 51503-4626
Phone (712) 396-7495

Hospital & facility affiliations

  • Methodist Jennie Edmundson Hospital, Council Bluffs, IA, CCN 160047
  • Cass County Memorial Hospital Hospital, Atlantic, IA, CCN 161376
  • The Nebraska Methodist Hospital Hospital, Omaha, NE, CCN 280040
  • Montgomery County Memorial Hospital Hospital, Red Oak, IA, CCN 161363
  • Shenandoah Medical Center Hospital, Shenandoah, IA, CCN 161366

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
77345WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Methodist Hospital Current Accepting new patients
Avera St Anthonys Hospital Current Accepting new patients
Nebraska Methodist Hospital Current Accepting new patients
Apogee Medical Group, Wisconsin, S.C CurrentSince Aug 17, 2022 Accepting new patients
Physicians Clinic Inc Family Medicine CurrentSince Jul 18, 2023 Accepting new patients
Jennie Edmundson Memorial Hospital Past Accepting new patients

Locations

15059 N Scottsdale Rd
Ste 600
Scottsdale, AZ 85254
Phone (602) 778-3601

1 Edmundson Pl
Ste 310
Council Bluffs, IA 51503
Phone (712) 328-1801

1 Edmundson Pl
Council Bluffs, IA 51503
Phone (712) 396-4000

933 E Pierce St
Council Bluffs, IA 51503
Phone (712) 328-6000

1319 Leavenworth St
Omaha, NE 68102
Phone (402) 552-2050

825 S 169th St
Fl 3
Omaha, NE 68118
Phone (402) 354-5451

125 Hospital Dr
Watertown, WI 53098
Phone (920) 261-4210

Interoperability endpoints

  • Direct secure messaging: eschneider1062404@direct.unitypoint.org
  • Direct secure messaging: ethan.schneider@direct.nmhs.org

Organizations & group practices 6

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 5

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": "1555027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1083177224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 E. PIERCE ST.",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515034626",
            "telephone_number": "712-396-4360",
            "fax_number": "712-396-7069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 E. PIERCE ST.",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515034626",
            "telephone_number": "712-396-4360",
            "fax_number": "712-396-7069"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7400 W State St Apt 220",
            "address_purpose": "LOCATION",
            "city": "Wauwatosa",
            "state": "WI",
            "postal_code": "532132725",
            "country_code": "US",
            "telephone_number": "402-340-6764",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1319 Leavenworth St",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681023215",
            "country_code": "US",
            "telephone_number": "402-552-3222",
            "fax_number": "402-552-2172",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHNEIDER",
        "first_name": "ETHAN",
        "middle_name": "CLAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-12",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "77345",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IA",
            "license": "MD-51235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

Verify at the official NPI Registry.