Individual provider Active NPI

John J. Tennity, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Lincoln, NE
National Provider Identifier
1194728915
Registry record updated Jan 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
237 Issued in NE
Practice address
1150 N 83Rd St
Lincoln, NE 68505-2094
Phone
(402) 483-4485
Fax
(402) 483-5372
NPI assigned
May 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 237 NE Primary

Addresses

Primary practice location

1150 N 83Rd St
Lincoln, NE 68505-2094

Mailing address

1150 N 83Rd St
Lincoln, NE 68505-2094
Phone (402) 483-4485

Other identifiers 4

IdentifierTypeStateIssuer
47083655807MedicaidNE
48033679OtherNERAILROAD MEDICARE
2572OtherNEBLUE CROSS BLUE SHIELD ID
27-00182OtherNEUNITED HEALTHCARE ID

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100820001104 NE Practitioner - Podiatry 4789775966 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bryan Physician NetworkGroup PAC ID 7315915873, 236 clinicians

Practice addresses (Care Compare)

1600 S 48TH St
Lincoln, NE 68506-1299

2300 S 16TH St
Bryan Medical Center
Lincoln, NE 68502-3704
Phone (402) 481-1111

5055 A St
Lincoln, NE 68510-4970

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue144
Removal or shaving of skin growth37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
237NEMDErgonomics Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bryan Physician Network CurrentSince Feb 1, 2021 Accepting new patients
Bryan Physician Network Foot & Ankle Surgery PastSince Jan 1, 2021 Accepting new patients
Northwoods Surgery Center LLC PastSince May 14, 2001 Accepting new patients

Locations

5055 A St
Ste 400
Lincoln, NE 68510
Phone (402) 483-3890

2300 S 16th St
Lincoln, NE 68502
Phone (402) 434-6042

Interoperability endpoints

  • Direct secure messaging: jtennity14936@hisp.bryanhealth.org

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 and National Provider Directory roles.

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": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327881600000",
    "number": "1194728915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 N 83RD ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685052094",
            "telephone_number": "402-483-4485",
            "fax_number": "402-483-5372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 N 83RD ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685052094",
            "telephone_number": "402-483-4485",
            "fax_number": "402-483-5372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENNITY",
        "first_name": "JOHN",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2012-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NE",
            "license": "237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47083655807",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "48033679",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD ID",
            "identifier": "2572",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE ID",
            "identifier": "27-00182",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.