Individual provider Active NPI

Kyle A Papousek, D.D.S.

  • General Practice Dentistry
  • Norfolk, NE
National Provider Identifier
1225359169
Registry record updated Jun 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6900 Issued in NE
Practice address
513 S 13TH St
Norfolk, NE 68701-4966
Phone
(402) 379-2775
Fax
(402) 379-0120
NPI assigned
Jun 15, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6900 NE Primary

Addresses

Primary practice location

513 S 13TH St
Norfolk, NE 68701-4966

Mailing address

513 S 13TH St
Norfolk, NE 68701-4966
Phone (402) 379-2775

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
I20150317000364 NE Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4880911643

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6900NEMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Family First Dental Associates of Nebraska, P.C. General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1276560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276560000000",
    "number": "1225359169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 S 13TH ST",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687014966",
            "telephone_number": "402-379-2775",
            "fax_number": "402-379-0120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 S 13TH ST",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687014966",
            "telephone_number": "402-379-2775",
            "fax_number": "402-379-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPOUSEK",
        "first_name": "KYLE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-15",
        "last_updated": "2010-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "6900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, NE

Sources for this page

Verify at the official NPI Registry.