Individual provider Active NPI

Cassidy Pietryga, AUD

  • Audiologist
  • Omaha, NE
National Provider Identifier
1225608607
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
411 Issued in NE
Practice address
555 N 30TH St
Omaha, NE 68131-2136
Phone
(531) 355-6693
NPI assigned
Jun 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 411 NE Primary

Addresses

Primary practice location

555 N 30TH St
Omaha, NE 68131-2136

Mailing address

4614 S 132ND St
Omaha, NE 68137-1764
Phone (402) 330-3211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210707001158 NE Practitioner - Qualified Audiologist 1850793399 Reassigns benefits to 1 organization
I20220628000477 IA Practitioner - Qualified Audiologist 1850793399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Father Flanagans Boys HomeGroup PAC ID 9638165400, 93 clinicians

Practice addresses (Care Compare)

320 McKenzie Ave
Suite 202
Council Bluffs, IA 51503-1002
Phone (712) 256-5272

555 N 30TH St
Boys Town National Research Hospital Downto
Omaha, NE 68131-2136
Phone (531) 355-1234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
411NEMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Father Flanagan'S Boys' Home Audiologist CurrentSince Apr 18, 2022 Accepting new patients
Father Flanagan'S Boys Home Past Accepting new patients
Makovicka Harms Group PC PastSince Jul 1, 2021 Accepting new patients
ENT Services PC Audiologist Past Accepting new patients

Locations

320 McKenzie Ave
Ste 202
Council Bluffs, IA 51503
Phone (712) 256-5272

14080 Boys Town Hospital Rd
Boys Town, NE 68010
Phone (402) 778-6900

555 N 30th St
Omaha, NE 68131
Phone (402) 280-8100

Organizations & group practices 4

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": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1225608607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4614 S 132ND ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681371764",
            "telephone_number": "402-330-3211",
            "fax_number": "402-330-5970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 N 30TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312136",
            "telephone_number": "531-355-6693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIETRYGA",
        "first_name": "CASSIDY",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NE",
            "license": "411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.