Michael Pettis, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

18239 Issued in NE

Practice address

7500 Mercy Rd
Omaha, NE 68124

Phone

(402) 343-8760

Fax

(402) 343-8765

NPI assigned

Aug 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Anesthesiology

Education

University of Nebraska College of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CHI Health Clinic Physician Enterprise-Anesthesia LLCGroup PAC ID 2264794569, 224 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CHI Health Bergan Mercy Hospital, Omaha, NE, CCN 280060
• CHI Health Lakeside Hospital, Omaha, NE, CCN 280130

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• CHI Health Clinic Physician Enterprise-Anesthesia LLC

  • Anesthesiology Physician
  • Omaha, NE
  • NPI 1356858419
  Medicare reassignment Care Compare group NPD
• Alegent Creighton Clinic

  • Family Medicine Physician
  • Omaha, NE
  • NPI 1548287907
  Medicare reassignment NPD
• Metro Omaha Anesthesia PC

  • Anesthesiology Physician
  • Omaha, NE
  • NPI 1558884072
  Medicare reassignment NPD
• CHI Health Clinic Specialty, LLC

  • Hospitalist Physician
  • Lincoln, NE
  • NPI 1285138065
  NPD (past)
• Alegent Creighton Clinic

  • Family Medicine Physician
  • Council Bluffs, IA
  • NPI 1598811069
  NPD (past)
• Anesthesia Associates of Central Iowa PC

  • Certified Registered Nurse Anesthetist
  • Ames, IA
  • NPI 1760563308
  NPD (past)
• CHI Health Clinic Physician Enterprise-Anesthesia LLC

  • Anesthesiology Physician
  • Council Bluffs, IA
  • NPI 1639687114
  NPD (past)

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
• Alegent Health Bergan Mercy Health System

  • Psychiatric Hospital Unit
  • Omaha, NE
  • NPI 1396969499
  Care Compare affiliation
• Alegent Health Bergan Mercy Health System

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1508941097
  Care Compare affiliation

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144334665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7710 MERCY RD SUITE 424",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68124",
            "telephone_number": "402-343-8760",
            "fax_number": "402-343-8765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 MERCY RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68124",
            "telephone_number": "402-343-8760",
            "fax_number": "402-343-8765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIS",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NE",
            "license": "18239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47079756000",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandon Jamar Pettis
• Eric Pettis
• Kate Pettis
• Kelsey Ann-Cherie Pettis
• Malayah Marie Pettis
• Shawn James Pettis, MD
• Baleigh Renee Pettit, CNA
• Justin Michael Pettit, DPT
• Kara Pettit, MS OTR/L
• Aubrie Petts

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.