NPIMap

Individual provider Active NPI

Raymond D. Heller, M.D.

  • Family Medicine Physician
  • Superior, NE
National Provider Identifier
1124137039
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
21937 Issued in NE
Practice address
510 E 10TH St
Superior, NE 68978-1225
Phone
(402) 879-3281
Fax
(402) 879-3401
NPI assigned
Aug 30, 2006
Last updated
Dec 5, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 21937 NE Primary

Addresses

Primary practice location

510 E 10TH St
Superior, NE 68978-1225

Mailing address

302 W Phillip Ave
Norfolk, NE 68701-5248
Phone (402) 371-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040304000882 NE Practitioner - Family Practice 7214825025 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Creighton University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Good Neighbor Community Health CenterGroup PAC ID 0840100392, shared by 2 NPIs, 16 clinicians
Brodstone Memorial HospitalGroup PAC ID 4082513015, shared by 5 NPIs, 12 clinicians

Practice addresses (Care Compare)

2740 N Clarkson St
Fremont, NE 68025-7702
Phone (402) 721-0951

4321 41St Ave
Columbus, NE 68601-2131
Phone (402) 562-7500

520 E 10TH St
Superior, NE 68978-1225
Phone (402) 879-3281

5427 Hwy 136
Brodstone Family Medical Center Deshler
Deshler, NE 68340-9845
Phone (402) 207-1132

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.6 of 100Reported as apm
Quality
82.13
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21937NEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brodstone Memorial Hospital Family Medicine CurrentSince Dec 18, 2023 Accepting new patients
Brodstone Memorial Hospital Current Accepting new patients
Metro Omaha Anesthesia PC CurrentSince Jul 1, 2019 Accepting new patients
Brodstone Memorial Hospital CurrentSince Dec 18, 2023 Accepting new patients
Creighton University Family Medicine Past Accepting new patients
Alegent Creighton Clinic Family Medicine Past Accepting new patients
Alegent Creighton Clinic Family Medicine Past Accepting new patients
Creighton University Past Accepting new patients

Locations

10780 V St
Omaha, NE 68127
Phone (402) 502-5599

3201 S 24th St
Omaha, NE 68108
Phone (402) 345-9132

520 E 10th St
Superior, NE 68978
Phone (402) 224-3344

525 E 11th St
Superior, NE 68978
Phone (402) 879-4781

Organizations & group practices 10

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1124137039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 W PHILLIP AVE",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687015248",
            "telephone_number": "402-371-8000",
            "fax_number": "402-371-0971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 E 10TH ST",
            "city": "SUPERIOR",
            "state": "NE",
            "postal_code": "689781225",
            "telephone_number": "402-879-3281",
            "fax_number": "402-879-3401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELLER",
        "first_name": "RAYMOND",
        "middle_name": "D.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "21937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Superior, NE

Sources for this page

Verify at the official NPI Registry.