Individual provider Active NPI

Joseph V Petty III, M.D.

  • Anesthesiology Physician
  • Lincoln, NE
National Provider Identifier
1235286543
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
19306 Issued in NE
Practice address
7500 S 91St St
Lincoln, NE 68526-9437
Phone
(402) 328-3079
Fax
(402) 328-3288
NPI assigned
Jan 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 19306 NE Primary

Addresses

Primary practice location

7500 S 91St St
Lincoln, NE 68526-9437

Mailing address

7500 S 91St St
Lincoln, NE 68526-9437
Phone (402) 328-3079

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110901000152 NE Practitioner - Anesthesiology 1456521327 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7500 S 91St St
CHI Health Nebraska Heart Inst.
Lincoln, NE 68526-9437
Phone (402) 489-6555

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19306NEMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CHI Health Clinic Physician Enterprise-Anesthesia LLC Anesthesiology CurrentSince Jan 1, 2019 Accepting new patients
Associated Anesthesiologists PC Anesthesiology PastSince Feb 25, 2024 Accepting new patients
CHI Health Clinic Physician Enterprise-Anesthesia LLC Anesthesiology Past Accepting new patients

Locations

7500 S 91st St
Lincoln, NE 68526
Phone (402) 327-2700

7500 Mercy Rd
Ste 1355
Omaha, NE 68124
Phone (402) 717-4866

Organizations & group practices 3

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.

Hospital & facility affiliations 5

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": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1235286543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 S 91ST ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685269437",
            "telephone_number": "402-328-3079",
            "fax_number": "402-328-3288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 S 91ST ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685269437",
            "telephone_number": "402-328-3079",
            "fax_number": "402-328-3288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "JOSEPH",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-05",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NE",
            "license": "19306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.