Individual provider Active NPI

Justin Lee Makovicka, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Elkhorn, NE
National Provider Identifier
1144676966
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
54622 Issued in AZ
Practice address
222 N 192ND St
Elkhorn, NE 68022-5363
Phone
(402) 390-4111
Fax
(402) 390-4115
NPI assigned
May 11, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 54622 AZ
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 54622 AZ Primary

Addresses

Primary practice location

222 N 192ND St
Elkhorn, NE 68022-5363

Mailing address

8005 Farnam Dr Ste 305
Omaha, NE 68114-3426
Phone (402) 390-4111

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmakovicka388931@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230822002462 NE Practitioner - Orthopedic Surgery 2264724269 Reassigns benefits to 1 organization
I20231016000528 IA Practitioner - Sports MedicinePractitioner - Orthopedic Surgery 2264724269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Orthopedic Surgery
Education
University of Nebraska College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MD West One PCGroup PAC ID 0446228852, 89 clinicians

Practice addresses (Care Compare)

1 Edmundson PL
Suite 200
Council Bluffs, IA 51503-4658
Phone (402) 390-4111

222 N 192ND St
Elkhorn, NE 68022-2811
Phone (402) 390-4111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.57 of 100Reported as group
Quality
76.1
Promoting interoperability
95
Improvement activities
40
Cost
76.63

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement62
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54622AZMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MD West One, PC Orthopaedic Surgery CurrentSince Aug 15, 2023 Accepting new patients
MD West One, PC Orthopaedic Surgery CurrentSince Aug 15, 2023 Accepting new patients

Locations

1 Edmundson Pl
Ste 200
Council Bluffs, IA 51503
Phone (712) 243-3250

2959 US Highway 275
Hamburg, IA 51640
Phone 71238215158070

222 N 192nd St
Elkhorn, NE 68022

3301 E Elkhorn Dr
Ste 100
Fremont, NE 68025
Phone (402) 721-0090

8005 Farnam Dr
Ste 305
Omaha, NE 68114

5908 S 142nd St
Omaha, NE 68137
Phone (402) 354-1900

Interoperability endpoints

  • Direct secure messaging: jmakovicka388931@ehrdirect.mayoclinicmsg.org

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.

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": "1462924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1144676966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8005 FARNAM DR STE 305",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681143426",
            "telephone_number": "402-390-4111",
            "fax_number": "402-390-4115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 N 192ND ST",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680225363",
            "telephone_number": "402-390-4111",
            "fax_number": "402-390-4115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKOVICKA",
        "first_name": "JUSTIN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-11",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "54622",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "AZ",
            "license": "54622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmakovicka388931@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "13400 E Shea Blvd",
            "city": "Scottsdale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852595452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elkhorn, NE

Sources for this page

Verify at the official NPI Registry.