Mary Hall, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2002 Issued in NE

Practice address

16901 Lakeside Hills CT
Attn: Hospital Medicine
Omaha, NE 68130-2318

Phone

(855) 524-4001

Fax

(402) 717-7340

NPI assigned

Feb 23, 2016

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

Medicare fee-for-service enrollment

Enrolled in NE, IA2 enrollments

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 2

Specialty

Physician Assistant

Education

University of Nebraska College of Medicine, 2015

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 Lakeside Hospital, Omaha, NE, CCN 280130

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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
• Alegent Creighton Clinic

  • Family Medicine Physician
  • Council Bluffs, IA
  • NPI 1598811069

  Physician Assistant

  Medicare reassignment NPD (past)
• CHI Health Clinic Specialty, LLC

  • Hospitalist Physician
  • Lincoln, NE
  • NPI 1285138065
  Medicare reassignment
• Alegent Creighton Clinic

  • Internal Medicine Physician
  • Omaha, NE
  • NPI 1518227859
  NPD

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

• Alegent Creighton Health

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1649355132
  Care Compare affiliation

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

{
    "created_epoch": "1456185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474416000000",
    "number": "1104285865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7261 MERCY RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16901 LAKESIDE HILLS CT",
            "address_2": "ATTN: HOSPITAL MEDICINE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681302318",
            "telephone_number": "855-524-4001",
            "fax_number": "402-717-7340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "MARY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-23",
        "last_updated": "2016-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "2002",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "081276",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim Hall
• Lily Hall
• Lisa Hall
• Ma'Shai Hall
• Makayla Alexis Hall
• Megan Hall, RD
• Mercedes Hall
• Michael R Hall, DO
• Michaela Hall
• Michaella Erin Hall

• Physician Assistant in Omaha, NE
• Providers in Omaha, NE by specialty
• Physician Assistant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2016; 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.