Midwest Pathology Specialists PLC

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

Legal business name

MIDWEST PATHOLOGY SPECIALISTS PLC

Practice address

4955 F Street
Omaha, NE 68117

Phone

(402) 717-2875

Fax

(402) 717-5231

NPI assigned

Apr 12, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Wayne Penka, MD

Title

Billing Specialist

Phone

(402) 717-2875

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• None Doing business as

Locations

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422230400000",
    "number": "1194789867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4907",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68104",
            "telephone_number": "800-831-2402",
            "fax_number": "843-569-8503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4955 F STREET",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68117",
            "telephone_number": "402-717-2875",
            "fax_number": "402-717-5231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST PATHOLOGY SPECIALISTS PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-12",
        "last_updated": "2015-01-26",
        "status": "A",
        "authorized_official_last_name": "PENKA",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_title_or_position": "BILLING SPECIALIST",
        "authorized_official_telephone_number": "402-717-2875",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Cytopathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CD8493",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "44191",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0508986",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "None",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Anatomic Pathology & Clinical Pathology Physician in Omaha, NE
• Providers in Omaha, NE by specialty
• Anatomic Pathology & Clinical Pathology Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.