Individual provider Active NPI

Stephen P Moessner, M.D.

  • Anesthesiology Physician
  • Omaha, NE
National Provider Identifier
1104908219
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
16467 Issued in NE
Practice address
11704 W Center Rd Ste 110
Omaha, NE 68144-4327
Phone
(402) 691-1575
Fax
(402) 341-8565
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 16467 NE Primary

Addresses

Primary practice location

11704 W Center Rd Ste 110
Omaha, NE 68144-4327

Mailing address

11704 W Center Rd Ste 110
Omaha, NE 68144-4327
Phone (402) 691-1575

Other identifiers 3

IdentifierTypeStateIssuer
6910141MedicaidIA
01573OtherNEBCBS
10025014200MedicaidNE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070503000623 NE Practitioner - Anesthesiology 2163446378 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Nebraska College of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11704 W Ctr Rd
Suite 110
Omaha, NE 68144-4327
Phone (402) 212-0847

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Anesthesia Services PC Anesthesiology CurrentSince May 1, 2007 Accepting new patients
Private Anesthesia Associates, P.C. Anesthesiology PastSince Jul 1, 2004 Accepting new patients

Locations

4239 Farnam St
Ste 502
Omaha, NE 68131
Phone (402) 552-2886

11704 W Center Rd
Ste 110
Omaha, NE 68144
Phone (402) 212-0847

Organizations & group practices 3

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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1104908219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11704 W CENTER RD STE 110",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681444327",
            "telephone_number": "402-691-1575",
            "fax_number": "402-341-8565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11704 W CENTER RD STE 110",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681444327",
            "telephone_number": "402-691-1575",
            "fax_number": "402-341-8565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOESSNER",
        "first_name": "STEPHEN",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NE",
            "license": "16467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6910141",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01573",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025014200",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.