Individual provider Active NPI

Stephen B Smith, M.D.

  • Pulmonary Disease Physician
  • Omaha, NE
National Provider Identifier
1194740126
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
15541 Issued in NE
Practice address
1320 S 79TH St
Omaha, NE 68124-1411
Phone
(402) 681-0455
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 15541 NE Primary

Addresses

Primary practice location

1320 S 79TH St
Omaha, NE 68124-1411

Mailing address

1320 S 79TH St
Omaha, NE 68124-1411
Phone (402) 502-8787

Other identifiers 2

IdentifierTypeStateIssuer
30460OtherNEBCBS OF NE
10025284600MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050905000011 NE Practitioner - Pulmonary Disease 2668372459 Practice locations: Wayne, NE; Scottsbluff, NE; Pawnee City, NE; Osceola, NE; Oakland, NE; Omaha, NE; Central City, NE; Genoa, NE
I20060418000603 IA Practitioner - Pulmonary Disease 2668372459 Practice locations: Omaha, NE

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
University of Kansas School of Med (KC/Wich/Sal), 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1320 S 79TH St
Omaha, NE 68124-1411
Phone (402) 681-0455

National Provider Directory

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1194740126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 S 79TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681241411",
            "telephone_number": "402-502-8787",
            "fax_number": "402-502-8788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 S 79TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681241411",
            "telephone_number": "402-681-0455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "STEPHEN",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NE",
            "license": "15541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NE",
            "identifier": "30460",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025284600",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.