Individual provider Active NPI

Stacy Lee Niemi, APRN

  • Family Nurse Practitioner
  • Omaha, NE
National Provider Identifier
1144415795
Registry record updated Aug 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
110898 Issued in NE
Practice address
17030 Lakeside Hills PLZ
Suite 102
Omaha, NE 68130-2396
Phone
(402) 758-5800
Fax
(402) 758-5809
NPI assigned
Sep 6, 2007
Last updated
Aug 26, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 110898 NE Primary

Addresses

Primary practice location

17030 Lakeside Hills PLZ
Suite 102
Omaha, NE 68130-2396

Mailing address

17030 Lakeside Hills PLZ
Suite 102
Omaha, NE 68130-2396
Phone (402) 758-5800

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080509000683 NE Practitioner - Nurse Practitioner 1951480342 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Internal Medicine Physicians P.C.Group PAC ID 4183727266, 11 clinicians

Practice addresses (Care Compare)

17030 Lakeside Hills PLZ
Suite 102
Omaha, NE 68130-4656
Phone (402) 758-5800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.19 of 100Reported as apm
Quality
88.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine Physicians P.C. CurrentSince Mar 15, 2008 Accepting new patients

Locations

17030 Lakeside Hills Plz
Ste 102
Omaha, NE 68130
Phone (402) 435-1400

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4492e985-44bf-43dd-a2f3-262f81a54d5c/

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.

Hospital & facility affiliations 4

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": "1189036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409011200000",
    "number": "1144415795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17030 LAKESIDE HILLS PLZ",
            "address_2": "SUITE 102",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681302396",
            "telephone_number": "402-758-5800",
            "fax_number": "402-758-5809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17030 LAKESIDE HILLS PLZ",
            "address_2": "SUITE 102",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681302396",
            "telephone_number": "402-758-5800",
            "fax_number": "402-758-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEMI",
        "first_name": "STACY",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-06",
        "last_updated": "2014-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "110898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.