Individual provider Active NPI

Jon J Bleicher, MD

  • Diagnostic Radiology Physician
  • Papillion, NE
National Provider Identifier
1114949930
Registry record updated Feb 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
16447 Issued in NE
Practice address
401 East Gold Coast Rd
Ste 102
Papillion, NE 68046-4782
Phone
(402) 339-8991
Fax
(402) 339-6741
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 16447 NE Primary

Addresses

Primary practice location

401 East Gold Coast Rd
Ste 102
Papillion, NE 68046-4782

Mailing address

401 East Gold Coast Rd
Ste 102
Papillion, NE 68046-4782
Phone (402) 339-8991

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23765NEMDDiagnostic Radiology Physician

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203984000000",
    "number": "1114949930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 EAST GOLD COAST RD",
            "address_2": "STE 102",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680464782",
            "telephone_number": "402-339-8991",
            "fax_number": "402-339-6741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 EAST GOLD COAST RD",
            "address_2": "STE 102",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680464782",
            "telephone_number": "402-339-8991",
            "fax_number": "402-339-6741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEICHER",
        "first_name": "JON",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2008-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NE",
            "license": "16447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Papillion, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.