Active NPI
Popp Cosmetic Surgery PC
- Plastic and Reconstructive Surgery Physician
- Omaha, NE
National Provider Identifier
1093979163
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic and Reconstructive Surgery Physician
- License
- 15046
- Legal business name
- POPP COSMETIC SURGERY PC
- Practice address
- 11919 Grant St
Suite 100
Omaha, NE 68164-3475 - Phone
- (402) 391-4558
- Fax
- (402) 391-7401
- NPI assigned
- Jul 17, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Jeffrey Collins Popp, MD
- Title
- President/Owner
- Phone
- (402) 391-4558
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic and Reconstructive Surgery Physician | 2086S0122X | 15046 | NE | Primary |
Addresses
Primary practice location
11919 Grant St
Suite 100
Omaha, NE 68164-3475
Mailing address
11919 Grant St
Suite 100
Omaha, NE 68164-3475
Phone (402) 391-4558
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13-00055 | Other | NE | UNITED HEALTHCARE |
| 497 | Other | NE | MIDLANDS CHOICE |
| 01644 | Other | NE | BLUECROSS BLUESHIELD |
| F235478 | Other | NE | MIDLANDS CHOICE |
| 180011030 | Other | NE | RAILROAD MEDICARE |
| 03330 | Other | NE | BLUECROSS BLUESHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100224000715 | NE | Part B Supplier - Clinic/Group Practice | 5395888960 |
Receives reassigned benefits from 1 practitioner Practice locations: Omaha, NE |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
National Provider Directory
National Provider Directory- Tax ID family
- Popp Cosmetic Surgery PC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Ambulatory Surgical Clinic/Center
- Omaha, NE
- NPI 1013984665
Locations
11919 Grant St
Ste 100
Omaha, NE 68164
Phone (402) 391-4558
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Plastic and Reconstructive Surgery Physician
- Omaha, NE
- NPI 1417924051
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216252800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1216252800000",
"number": "1093979163",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11919 GRANT ST",
"address_2": "SUITE 100",
"city": "OMAHA",
"state": "NE",
"postal_code": "681643475",
"telephone_number": "402-391-4558",
"fax_number": "402-391-7401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11919 GRANT ST",
"address_2": "SUITE 100",
"city": "OMAHA",
"state": "NE",
"postal_code": "681643475",
"telephone_number": "402-391-4558",
"fax_number": "402-391-7401"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "POPP COSMETIC SURGERY PC",
"organizational_subpart": "NO",
"enumeration_date": "2008-07-17",
"last_updated": "2008-07-17",
"status": "A",
"authorized_official_last_name": "POPP",
"authorized_official_first_name": "JEFFREY",
"authorized_official_middle_name": "COLLINS",
"authorized_official_title_or_position": "PRESIDENT/OWNER",
"authorized_official_telephone_number": "402-391-4558",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2086S0122X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Surgery, Plastic and Reconstructive Surgery",
"state": "NE",
"license": "15046",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "13-00055",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MIDLANDS CHOICE",
"identifier": "497",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "01644",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MIDLANDS CHOICE",
"identifier": "F235478",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "180011030",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "03330",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.