Individual provider Active NPI

Stephanie M Braith, PA-C

  • Physician Assistant
  • Omaha, NE
National Provider Identifier
1265704266
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1634 Issued in NE
Practice address
4920 S 30TH St
Suite 103
Omaha, NE 68107-1590
Phone
(402) 734-4110
Fax
(402) 734-3990
NPI assigned
Feb 7, 2012
Last updated
Sep 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 12424 MN
Physician Assistant 363A00000X 1634 NE Primary

Addresses

Primary practice location

4920 S 30TH St
Suite 103
Omaha, NE 68107-1590

Mailing address

4920 S 30TH St Ste 103
Omaha, NE 68107-1656
Phone (402) 734-4110

Other practice location 1

200 1st St SW
Rochester, MN 55905-1590
Phone (507) 284-2511

Other names 1

  • Stephanie M Hall Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121010000484 NE Practitioner - Physician Assistant 4789833500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oneworld Community Health Centers IncGroup PAC ID 3173435153, shared by 17 NPIs, 56 clinicians

Practice addresses (Care Compare)

122 S 6TH St
Plattsmouth, NE 68048-1934
Phone (402) 296-2345

4910 S 30TH St
Omaha, NE 68107-1519
Phone (402) 734-4110

4920 S 30TH St
Omaha, NE 68107-1656
Phone (402) 734-4110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1634NEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Oneworld Community Health Centers, Inc. CurrentSince Nov 1, 2024 Accepting new patients
Oneworld Community Health Centers, Inc. CurrentSince Nov 1, 2024 Accepting new patients
Oneworld Community Health Centers, Inc. Past Accepting new patients
Oneworld Community Health Centers, Inc. Past Accepting new patients

Locations

2207 Georgia Ave
Bellevue, NE 68005
Phone (402) 502-8855

2021 Saint Marys Ave
Omaha, NE 68102
Phone (402) 505-8180

2520 S 130th Ave
Omaha, NE 68144
Phone (402) 769-7077

2723 Q St
Omaha, NE 68107
Phone (402) 715-5440

3121 U St
Omaha, NE 68107
Phone (402) 933-4968

4101 S 120th St
Omaha, NE 68137
Phone (402) 505-3907

4229 N 90th St
Omaha, NE 68134
Phone (402) 401-6000

4310 S 24th St
Omaha, NE 68107
Phone (402) 502-8841

4700 Giles Rd
Omaha, NE 68157
Phone (402) 991-3904

4920 S 30th St
Ste 103
Omaha, NE 68107

5616 L St
Omaha, NE 68117
Phone (402) 952-4050

122 S 6th St
Plattsmouth, NE 68048
Phone (402) 296-2345

Interoperability endpoints

  • Direct secure messaging: stephanie.braith.p1@direct.oneworldomaha.nextgenshare.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1328572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1265704266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4920 S 30TH ST STE 103",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681071656",
            "telephone_number": "402-734-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4920 S 30TH ST",
            "address_2": "SUITE 103",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681071590",
            "telephone_number": "402-734-4110",
            "fax_number": "402-734-3990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559051590",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAITH",
        "first_name": "STEPHANIE",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-07",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12424",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "HALL",
            "middle_name": "M",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.