Individual provider Active NPI

Brandy S. Reineke, P.A.

  • Medical Physician Assistant
  • Omaha, NE
National Provider Identifier
1093704926
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1226 Issued in NE
Practice address
6360 John J Pershing Dr FL 2
Omaha, NE 68110-1100
Phone
(402) 935-8100
Fax
(402) 935-8101
NPI assigned
Oct 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1226 NE Primary

Addresses

Primary practice location

6360 John J Pershing Dr FL 2
Omaha, NE 68110-1100

Mailing address

8920 Fremont St Apt 225
Lincoln, NE 68507-2290
Phone (402) 202-1397

Other identifiers 1

IdentifierTypeStateIssuer
38587OtherNEBCBS OF NEBRASKA

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
I20051121000417 NE Practitioner - Physician Assistant 6103845060 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1226NEMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New Century Physicians of Nebraska LLC CurrentSince Jan 1, 2006 Accepting new patients
Omaha Emergency Physicians PC Past Accepting new patients
Emergency Physicians of Eastern Nebraska, PC Past Accepting new patients
Urgent Care Group LLC Past Accepting new patients

Locations

16901 Lakeside Hills Ct
Omaha, NE 68130
Phone (402) 572-6500

11111 S 84th St
Papillion, NE 68046
Phone (402) 593-3000

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1093704926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8920 FREMONT ST APT 225",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685072290",
            "telephone_number": "402-202-1397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6360 JOHN J PERSHING DR FL 2",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681101100",
            "telephone_number": "402-935-8100",
            "fax_number": "402-935-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REINEKE",
        "first_name": "BRANDY",
        "middle_name": "S.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-13",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "1226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NEBRASKA",
            "identifier": "38587",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.