Individual provider Active NPI

Rebecca J Siecke, PA

  • Surgical Physician Assistant
  • Omaha, NE
National Provider Identifier
1154599942
Registry record updated Nov 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
1378 Issued in NE
Practice address
8200 Dodge Street
Children's Hospital - Cardiothoracic Surgery
Omaha, NE 68114-4113
Phone
(402) 955-4360
Fax
(402) 955-4364
NPI assigned
Feb 14, 2008
Last updated
Nov 24, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 1378 NE Primary

Addresses

Primary practice location

8200 Dodge Street
Children's Hospital - Cardiothoracic Surgery
Omaha, NE 68114-4113

Mailing address

8200 Dodge Street
Children's Hospital
Omaha, NE 68114-4113
Phone (402) 955-5400

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
I20140211000886 NE Practitioner - Physician Assistant 6406085604 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1378NEMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Nebraska Pediatric Practice, Inc Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1202947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259020800000",
    "number": "1154599942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8200 DODGE STREET",
            "address_2": "CHILDREN'S HOSPITAL",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144113",
            "telephone_number": "402-955-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 DODGE STREET",
            "address_2": "CHILDREN'S HOSPITAL - CARDIOTHORACIC SURGERY",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144113",
            "telephone_number": "402-955-4360",
            "fax_number": "402-955-4364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIECKE",
        "first_name": "REBECCA",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-14",
        "last_updated": "2009-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NE",
            "license": "1378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.