NPIMap

Individual provider Active NPI

Tanja L Noecker, PA-C

  • Medical Physician Assistant
  • Lincoln, NE
National Provider Identifier
1194733709
Registry record updated Feb 27, 2008
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Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1209 Issued in NE
Practice address
4501 S 70TH St
Ste 130
Lincoln, NE 68516-4282
Phone
(402) 484-4940
Fax
(402) 484-4941
NPI assigned
Aug 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1209 NE Primary

Addresses

Primary practice location

4501 S 70TH St
Ste 130
Lincoln, NE 68516-4282

Mailing address

8055 O St
Ste 300
Lincoln, NE 68510-2580
Phone (402) 421-0896

Other identifiers 3

IdentifierTypeStateIssuer
248145OtherNEMIDLAND'S CHOICE
37837OtherNEBCBS - LINC CARE
37836OtherNEBCBS - ELIM

Other names 1

  • Tanja L Faust Former name

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
I20051020000885 NE Practitioner - Physician Assistant 3678599479 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
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)

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

5901 N 27TH St
Lincoln, NE 68521-4752

Hospital & facility affiliations

  • Interim Healthcare Home health agency, Lincoln, NE, CCN 287062
  • Eventide Home Health Care Home health agency, Lincoln, NE, CCN 287002
  • Bryan Medical Center Hospital, Lincoln, NE, CCN 280003
  • CHI Health St. Elizabeth Hospital, Lincoln, NE, CCN 280020

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
TRG Management Co, LLC Past Accepting new patients
Seward Urgent Care Partnership LLC Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Lincoln Physician Network LLC Past Accepting new patients

Organizations & group practices 5

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 6

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204070400000",
    "number": "1194733709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8055 O ST",
            "address_2": "STE 300",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102580",
            "telephone_number": "402-421-0896",
            "fax_number": "402-421-0945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 S 70TH ST",
            "address_2": "STE 130",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685164282",
            "telephone_number": "402-484-4940",
            "fax_number": "402-484-4941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOECKER",
        "first_name": "TANJA",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2008-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "1209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLAND'S CHOICE",
            "identifier": "248145",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - LINC CARE",
            "identifier": "37837",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - ELIM",
            "identifier": "37836",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TANJA",
            "last_name": "FAUST",
            "middle_name": "L",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.