NPIMap

Organization Active NPI

Multicare Medical Group PC

Doing business as Pain West

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Papillion, NE
National Provider Identifier
1144741406
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
Legal business name
MULTICARE MEDICAL GROUP PC
Doing business as
Pain West
Practice address
701 Pinnacle Dr Ste 105
Papillion, NE 68046-6228
Phone
(402) 505-7989
Fax
(402) 932-8863
NPI assigned
Jun 27, 2017
Last updated
Feb 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Authorized official

Name
Dr. Tonya L Boeckenhauer, DCNPI 1003054131
Title
Vice-President
Phone
(402) 505-7989

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X Primary

Addresses

Primary practice location

701 Pinnacle Dr Ste 105
Papillion, NE 68046-6228

Mailing address

741 Pinnacle Dr
Papillion, NE 68046-6269
Phone (402) 505-7989

Other names 1

  • Pain West Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170801000718 NE Part B Supplier - Clinic/Group Practice 6507137130 Receives reassigned benefits from 19 practitioners
Practice locations: Omaha, NE; Papillion, NE
O20171212001310 NE DME Supplier - Multi-Specialty - Physician 6507137130 Practice locations: Papillion, NE

National Provider Directory

National Provider Directory

Locations

701 Pinnacle Dr
Ste 103
Papillion, NE 68046

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1498521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675728000000",
    "number": "1144741406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 PINNACLE DR",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680466269",
            "telephone_number": "402-505-7989",
            "fax_number": "402-932-8863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 PINNACLE DR STE 105",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680466228",
            "telephone_number": "402-505-7989",
            "fax_number": "402-932-8863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MULTICARE MEDICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-27",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A",
        "authorized_official_last_name": "BOECKENHAUER",
        "authorized_official_first_name": "TONYA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "402-505-7989",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pain West",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Papillion, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.