Individual provider Active NPI

Nicolle M Mahoney, M.D.

  • Reproductive Endocrinology Physician
  • Lincoln, NE
National Provider Identifier
1255360491
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
License
22805 Issued in NE
Practice address
1500 S 48TH St
Suite 508
Lincoln, NE 68506-1225
Phone
(402) 483-2886
Fax
(402) 489-9684
NPI assigned
Jul 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Reproductive Endocrinology Physician 207VE0102X 22805 NE Primary

Addresses

Primary practice location

1500 S 48TH St
Suite 508
Lincoln, NE 68506-1225

Mailing address

1500 S 48TH St
Suite 508
Lincoln, NE 68506-1225
Phone (402) 483-2886

Other identifiers 1

IdentifierTypeStateIssuer
4705966613MedicaidNE

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
I20040715000781 NE Practitioner - Obstetrics/Gynecology 3971582768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Nebraska College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gynecology and Fertility, P.C.Group PAC ID 6608866264, 6 clinicians

Practice addresses (Care Compare)

1500 S 48TH St
Suite 508
Lincoln, NE 68506-1279
Phone (402) 483-2886

Hospital & facility affiliations

  • Bryan Medical Center Hospital, Lincoln, NE, CCN 280003
  • CHI Health St. Elizabeth Hospital, Lincoln, NE, CCN 280020

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22805NEMDReproductive Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gynecology & Fertility, P.C. Reproductive Endocrinology CurrentSince Aug 1, 2004 Accepting new patients
Bryan Medical Center Past Accepting new patients

Locations

1500 S 48th St
Ste 508
Lincoln, NE 68506
Phone (402) 483-2886

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255360491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S 48TH ST",
            "address_2": "SUITE 508",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685061225",
            "telephone_number": "402-483-2886",
            "fax_number": "402-489-9684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S 48TH ST",
            "address_2": "SUITE 508",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685061225",
            "telephone_number": "402-483-2886",
            "fax_number": "402-489-9684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHONEY",
        "first_name": "NICOLLE",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "NE",
            "license": "22805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4705966613",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.