Individual provider Active NPI

Amy L Jorgensen, PA-C

  • Physician Assistant
  • Norfolk, NE
National Provider Identifier
1083987804
Registry record updated Mar 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1640 Issued in NE
Practice address
301 N 27TH St
Ste 2
Norfolk, NE 68701-4401
Phone
(402) 844-8291
Fax
(402) 844-8292
NPI assigned
Feb 10, 2012
Sex
Female
Sole proprietor
No

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Faith Regional Physician Services LLC 194 clinicians

Practice addresses (Care Compare)

2701 W Norfolk Ave FL
Norfolk, NE 68701-4407

47452 268 Ave
Suite C
Humphrey, NE 68642-5178
Phone (402) 923-0150

Hospital & facility affiliations

  • Faith Health Hospital, Norfolk, NE, CCN 280125
  • Avera St Anthony'S Hospital Hospital, O' Neill, NE, CCN 281329
  • West Holt Memorial Hospital Hospital, Atkinson, NE, CCN 281343
  • Rock County Hospital Hospital, Bassett, NE, CCN 281333

Merit-based Incentive Payment System (MIPS)

Final score
80.77 of 100Reported as group
Quality
67.03
Promoting interoperability
96
Improvement activities
40
Cost
72.22

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.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20120411000580 NE Practitioner - Physician Assistant 7719148105 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2295NEMDClinical Social Worker
1640NEMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Faith Regional Physician Services, LLC CurrentSince Feb 13, 2012 Accepting new patients

Locations

47452 268 Ave
Ste C
Humphrey, NE 68642
Phone (402) 923-0150

110 N 29th St
Ste 201
Norfolk, NE 68701
Phone (402) 844-8121

301 N 27th St
Ste 20
Norfolk, NE 68701
Phone (402) 844-8325

301 N 27th St
Ste 2
Norfolk, NE 68701
Phone (402) 644-7654

2600 W Norfolk Ave
Ste 200
Norfolk, NE 68701
Phone (402) 844-8194

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Radiologic Technologist 247100000X 2295 NE
Physician Assistant 363A00000X 1640 NE Primary

Addresses

NPPES NPI Registry

Primary practice location

301 N 27TH St
Ste 2
Norfolk, NE 68701-4401

Mailing address

110 N 29TH St
Ste 2
Norfolk, NE 68701-4424
Phone (402) 844-8121

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 8, 2017.

{
    "created_epoch": "1328832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488931200000",
    "number": "1083987804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 N 29TH ST",
            "address_2": "STE 2",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687014424",
            "telephone_number": "402-844-8121",
            "fax_number": "402-844-8122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N 27TH ST",
            "address_2": "STE 2",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687014401",
            "telephone_number": "402-844-8291",
            "fax_number": "402-844-8292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORGENSEN",
        "first_name": "AMY",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-10",
        "last_updated": "2017-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": "NE",
            "license": "2295",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, NE

Sources for this page

Verify at the official NPI Registry.