Boshra Mohammed Rida, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

24739 Issued in NE

Practice address

2200 S 40TH St
Suite 104
Lincoln, NE 68506-2425

Phone

(402) 483-6000

Fax

(402) 483-6106

NPI assigned

Apr 16, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CHI Health St. Elizabeth Hospital, Lincoln, NE, CCN 280020
• Bryan Medical Center Hospital, Lincoln, NE, CCN 280003

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Alegent Creighton Clinic

  • Family Medicine Physician
  • Omaha, NE
  • NPI 1548287907
  Medicare reassignment Care Compare group NPD
• Lincoln Physician Network LLC

  • Urgent Care Clinic/Center
  • Lincoln, NE
  • NPI 1902116833
  NPD (past)
• Alegent Creighton Clinic

  • Family Medicine Physician
  • Council Bluffs, IA
  • NPI 1598811069
  NPD (past)

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

• Bryan Medical Center

  • General Acute Care Hospital
  • Lincoln, NE
  • NPI 1528006103
  Care Compare affiliation
• Bryan Medical Center

  • Clinical Medical Laboratory
  • Lincoln, NE
  • NPI 1689203077

  Hospital

  Care Compare affiliation
• Bryan Medical Center

  • Diagnostic Radiology Physician
  • Lincoln, NE
  • NPI 1699384370

  Hospital

  Care Compare affiliation
• Saint Elizabeth Regional Medical Center

  • General Acute Care Hospital
  • Lincoln, NE
  • NPI 1336155738
  Care Compare affiliation

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385337600000",
    "number": "1093930133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 Q ST",
            "address_2": "SUITE 500",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685033609",
            "telephone_number": "402-421-0904",
            "fax_number": "402-421-0946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 S 40TH ST",
            "address_2": "SUITE 104",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685062425",
            "telephone_number": "402-483-6000",
            "fax_number": "402-483-6106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDA",
        "first_name": "BOSHRA",
        "middle_name": "MOHAMMED",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2013-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "0001684",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "24739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01629",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allyson B Rickertsen, M.S.
• Michael Bruce Rickertsen, CTA
• Kelli Ricky
• Sean Rico
• Afak Mohammed Rida
• Ayden Ridder-Koch
• Grant Thomas Ridder
• Brad A Riddle, D.MIN, LMHP
• Lindsay Riddle
• Elizabeth Rider

• Family Medicine Physician in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Family Medicine Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.