Individual provider Active NPI

Jena Nichole Mahoney

  • Nurse Practitioner
  • Omaha, NE
National Provider Identifier
1093318792
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
114772 Issued in NE
Practice address
312 S 15TH St
Omaha, NE 68102-2207
Phone
(402) 354-2273
Fax
(402) 815-9745
NPI assigned
Nov 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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 114772 NE Primary

Addresses

Primary practice location

312 S 15TH St
Omaha, NE 68102-2207

Mailing address

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

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
I20231209000116 NE Practitioner - Nurse Practitioner 8426463258 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
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)

312 S 15TH St
Omaha, NE 68102-2207
Phone (402) 354-2273

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hydr8, LLC CurrentSince Jun 14, 2024 Accepting new patients
Physicians Clinic Inc Family Medicine CurrentSince Mar 31, 2025 Accepting new patients
Muc-Papillion LLC PastSince Nov 5, 2023 Accepting new patients

Locations

18210 Wright St
Omaha, NE 68130
Phone (531) 999-1813

825 S 169th St
Omaha, NE 68118
Phone (402) 354-3370

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

312 S 15th St
Omaha, NE 68102
Phone (402) 354-2273

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": "1605571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1093318792",
    "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": "312 S 15TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681022207",
            "telephone_number": "402-354-2273",
            "fax_number": "402-815-9745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHONEY",
        "first_name": "JENA",
        "middle_name": "NICHOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-17",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NE",
            "license": "114772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.