Mary C Dek, MD

Individual provider Active NPI Pediatrics Physician · Elkhorn, NE

NPI 1124187984 · NPPES record last updated Oct 11, 2012

Key facts

NPI
1124187984
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
21199 (NE)
Practice address
18018 Burke Street
Elkhorn, NE 68022-4417
Phone
(402) 573-7337
NPI assigned
Dec 7, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Village Pointe Pediatrics, PC Pediatrics Past Accepting new patients
Village Pointe Pediatrics, PC Pediatrics Past
since Jun 1, 2007
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 21119 NE
Pediatrics Physician 208000000X 21199 NE Yes

Addresses

Primary practice location

18018 Burke Street
Elkhorn, NE 68022-4417

Mailing address

16811 Burke Street
Ste 101
Omaha, NE 68118
Phone (402) 573-7337

Other identifiers

IdentifierTypeStateIssuer
1200591MedicaidNE
1200408MedicaidNE
1201454MedicaidNE
24985OtherNEMIDLANDS CHOICE
34043OtherNEBCBS OF NEBRASKA
1200590MedicaidNE
1200592MedicaidNE
0538579MedicaidIA
1200405MedicaidNE
1538579MedicaidIA
1201173MedicaidNE

Other names

  • Dr. Mary C McGill Former name

Other providers in Elkhorn, NE

All providers in Elkhorn, NE · Pediatrics Physician in Nebraska

Sources for this page

Verify at the official NPI Registry.