NPIMap

Individual provider Active NPI

Jeffrey C Gotschall, M.D.

  • Family Medicine Physician
  • Columbus, NE
National Provider Identifier
1174525414
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
17701 Issued in NE
Practice address
1454 28TH Ave
Columbus, NE 68601-4944
Phone
(402) 564-2816
Fax
(402) 564-1312
NPI assigned
Jun 1, 2005
Last updated
Jan 11, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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 17701 NE Primary

Addresses

Primary practice location

1454 28TH Ave
Columbus, NE 68601-4944

Mailing address

1454 28TH Ave
Columbus, NE 68601-4944
Phone (402) 564-2816

Other identifiers 1

IdentifierTypeStateIssuer
47055169400MedicaidNE

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
I20100621000736 NE Practitioner - Family Practice 9931299229 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Nebraska College of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Columbus Medical Center, P.C.Group PAC ID 0749233757, 7 clinicians
Columbus Urgent Care LLCGroup PAC ID 1759578180, 8 clinicians

Practice addresses (Care Compare)

1454 28TH Ave
Columbus, NE 68601-4944
Phone (402) 564-2816

3100 23Rd St
Suite T
Columbus, NE 68601-3161
Phone (402) 562-5400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions24
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy41

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17701NEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbus Medical Center, P.C. Family Medicine CurrentSince Jul 23, 1990 Accepting new patients
Columbus Urgent Care LLC CurrentSince Dec 29, 2010 Accepting new patients
Columbus Community Hospital Inc PastSince Aug 27, 2007 Accepting new patients

Locations

1454 28th Ave
Columbus, NE 68601
Phone (402) 564-2816

3100 23rd St
Ste T
Columbus, NE 68601
Phone (402) 562-5400

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73377
  • Direct secure messaging: jgotschall@colmed.directbygreenway.com

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 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": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1174525414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1454 28TH AVE",
            "city": "COLUMBUS",
            "state": "NE",
            "postal_code": "686014944",
            "telephone_number": "402-564-2816",
            "fax_number": "402-564-1312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1454 28TH AVE",
            "city": "COLUMBUS",
            "state": "NE",
            "postal_code": "686014944",
            "telephone_number": "402-564-2816",
            "fax_number": "402-564-1312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTSCHALL",
        "first_name": "JEFFREY",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "17701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47055169400",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, NE

Sources for this page

Verify at the official NPI Registry.