Individual provider Active NPI

Austin Enfield, P-C

  • Physician Assistant
  • La Vista, NE
National Provider Identifier
1184334195
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2858 Issued in NE
Practice address
8248 S 96TH St
La Vista, NE 68128-3126
Phone
(402) 717-9500
NPI assigned
Nov 30, 2022
Last updated
Jan 30, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2858 NE Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

8248 S 96TH St
La Vista, NE 68128-3126

Mailing address

12058 Iva St
Gretna, NE 68028-4656

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
I20230329000954 NE Practitioner - Physician Assistant 2769856962 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians

Practice addresses (Care Compare)

16909 Lakeside Hills CT
Omaha, NE 68130-4661

8248 S 96TH St
La Vista, NE 68128-3126
Phone (402) 717-9500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2858NEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic CurrentSince Apr 18, 2023 Accepting new patients
Alegent Creighton Clinic CurrentSince Apr 18, 2023 Accepting new patients

Locations

2771 Solution Ctr
Chicago, IL 60677

8248 S 96th St
Lavista, NE 68128
Phone (402) 717-9500

16909 Lakeside Hills Ct
Ste 401
Omaha, NE 68130
Phone (402) 827-4920

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 3

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": "1669766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1184334195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12058 IVA ST",
            "city": "GRETNA",
            "state": "NE",
            "postal_code": "680284656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8248 S 96TH ST",
            "city": "LA VISTA",
            "state": "NE",
            "postal_code": "681283126",
            "telephone_number": "402-717-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENFIELD",
        "first_name": "AUSTIN",
        "credential": "P-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-11-30",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "2858",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Vista, NE

Sources for this page

Verify at the official NPI Registry.