Theresa A Jizba, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

111244 Issued in NE

Practice address

8303 Dodge St
Omaha, NE 68114-4108

Phone

(402) 354-2917

Fax

(402) 354-3160

NPI assigned

Dec 24, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Theresa A. Hackmann Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

University of Nebraska College of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nebraska Methodist HospitalGroup PAC ID 6901707447, 132 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Nebraska Methodist Hospital Hospital, Omaha, NE, CCN 280040

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Nebraska Methodist Hospital

  • Emergency Medicine Physician
  • Omaha, NE
  • NPI 1689628372

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Nebraska Methodist Hospital

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1427147883
  Care Compare affiliation

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

{
    "created_epoch": "1230076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1255577102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2797",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681032797",
            "telephone_number": "402-354-4230",
            "fax_number": "402-354-6171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8303 DODGE ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144108",
            "telephone_number": "402-354-2917",
            "fax_number": "402-354-3160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIZBA",
        "first_name": "THERESA",
        "middle_name": "A",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-24",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NE",
            "license": "111244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47037660432",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255577102",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "HACKMANN",
            "middle_name": "A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Nurse Practitioner in Omaha, NE
• Providers in Omaha, NE by specialty
• Nurse Practitioner in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.