Individual provider Active NPI

John A Osborne, D.O.

  • Surgery Physician
  • Omaha, NE
National Provider Identifier
1215021498
Registry record updated Jul 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
3305 Issued in TN
Practice address
4242 Farnam St
#370
Omaha, NE 68131
Phone
(402) 552-3078
Fax
(402) 552-3075
NPI assigned
Oct 3, 2006
Last updated
Jul 18, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 3305 TN Primary

Addresses

Primary practice location

4242 Farnam St
#370
Omaha, NE 68131

Mailing address

143 Kennedy Dr
Martin, TN 38237-3309
Phone (731) 587-5321

Other practice location 1

4242 Farnam St
#370
Omaha, NE 68131-2806
Phone (402) 552-3078

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20171108002925 TN Practitioner - General Surgery 2466351937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Rutgers School of Dental Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WT Medical AssociatesGroup PAC ID 1951650613, 64 clinicians

Practice addresses (Care Compare)

164 Mount Pelia Rd
Martin, TN 38237-3812
Phone (731) 285-5133

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.74 of 100Reported as apm
Quality
85.23
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy23
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux23
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
505NEMDCounselor
3305TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
WT Medical Associates CurrentSince Jun 1, 2018 Accepting new patients
WT Medical Associates CurrentSince Jun 1, 2018 Accepting new patients

Locations

420 Wilkinson Dr
Fl 2
Dyersburg, TN 38024
Phone (731) 285-5133

143 Kennedy Dr
Martin, TN 38237
Phone (731) 587-5321

164 Mount Pelia Rd
Martin, TN 38237
Phone (731) 587-5900

Interoperability endpoints

  • Direct secure messaging: josborne18727@directepic.wth.org

Organizations & group practices 2

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 2

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531872000000",
    "number": "1215021498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 KENNEDY DR",
            "city": "MARTIN",
            "state": "TN",
            "postal_code": "382373309",
            "telephone_number": "731-587-5321",
            "fax_number": "731-587-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4242 FARNAM ST",
            "address_2": "#370",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68131",
            "telephone_number": "402-552-3078",
            "fax_number": "402-552-3075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4242 Farnam St",
            "address_2": "#370",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681312806",
            "country_code": "US",
            "telephone_number": "402-552-3078",
            "fax_number": "402-552-3075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OSBORNE",
        "first_name": "JOHN",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2018-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "3305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.