NPIMap

Individual provider Active NPI

Jordan Moncrief, MD

  • Family Medicine Physician
  • Omaha, NE
National Provider Identifier
1164912002
Registry record updated May 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
8197 Issued in NE
Practice address
983075 Nebraska Medical Ctr
Omaha, NE 68198-3075
Phone
(402) 595-2275
NPI assigned
May 16, 2018
Last updated
May 16, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 8197 NE Primary

Addresses

Primary practice location

983075 Nebraska Medical Ctr
Omaha, NE 68198-3075

Mailing address

983075 Nebraska Medical Ctr
Omaha, NE 68198-3075
Phone (402) 595-2275

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210714003170 NE Practitioner - HospitalistPractitioner - Family Practice 0244580066 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Family Practice
Education
University of Nebraska College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CHI Health Clinic Specialty LLCGroup PAC ID 4789098443, 317 clinicians

Practice addresses (Care Compare)

10 E 31St St
CHI Health Good Samaritan
Kearney, NE 68847-2908
Phone (308) 865-7100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8197NEMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
CHI Health Clinic Specialty, LLC Family Medicine CurrentSince Jul 25, 2021 Accepting new patients
Good Samaritan Hospital Past Accepting new patients

Locations

10 E 31st St
Kearney, NE 68847
Phone (308) 234-5520

7440 S 91st St
Lincoln, NE 68526
Phone (402) 489-6554

8207 Northwoods Dr
Ste 100
Lincoln, NE 68505
Phone (402) 484-3440

Organizations & group practices 3

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 8

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": "1526428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526428800000",
    "number": "1164912002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "983075 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681983075",
            "telephone_number": "402-595-2275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "983075 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681983075",
            "telephone_number": "402-595-2275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONCRIEF",
        "first_name": "JORDAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-16",
        "last_updated": "2018-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "8197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.