Individual provider Active NPI

Elijah Tyler Frost, PA-C

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Omaha, NE
National Provider Identifier
1093449142
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
3080 Issued in NE
Practice address
42ND and Emile
Omaha, NE 68198-0001
Phone
(402) 559-4000
NPI assigned
Jul 14, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 3080 NE Primary

Addresses

Primary practice location

42ND and Emile
Omaha, NE 68198-0001

Mailing address

8922 Buckshot Rd
Lincoln, NE 68507-1196
Phone (402) 937-3003

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
I20240326003623 NE Practitioner - Physician Assistant 7517304512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unmc PhysiciansGroup PAC ID 6002728391, 1,490 clinicians

Practice addresses (Care Compare)

987400 Nebraska Medical Ctr
Unmc Physicians Nebraska Medical Center
Omaha, NE 68198-7400
Phone (402) 559-4000

Emile 42ND St
Omaha, NE 68198-0001
Phone (402) 559-4015

Hospital & facility affiliations

  • The Nebraska Medical Center Hospital, Omaha, NE, CCN 280013

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3080NEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Nebraska Pediatric Practice, Inc PastSince Jul 1, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: efrost371370@direct.nebraskamed.com

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 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": "1657756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1093449142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8922 BUCKSHOT RD",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685071196",
            "telephone_number": "402-937-3003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42ND AND EMILE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681980001",
            "telephone_number": "402-559-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FROST",
        "first_name": "ELIJAH",
        "middle_name": "TYLER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-14",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NE",
            "license": "3080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.