Active NPI
Stephanie M Braith, PA-C
- Physician Assistant
- Omaha, NE
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1634
- 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, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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
Enrollment records 1
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 Inc
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1634 | NE | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oneworld Community Health Centers, Inc. | Current | Accepting new patients | |
| Oneworld Community Health Centers, Inc. | Current | 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
- 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.
-
- Federally Qualified Health Center (FQHC)
- Omaha, NE
- NPI 1952330649
-
dba Buena Vista High School Based Health Center
- Federally Qualified Health Center (FQHC)
- Omaha, NE
- NPI 1043941719
-
- Federally Qualified Health Center (FQHC)
- Omaha, NE
- NPI 1982553186
-
- Federally Qualified Health Center (FQHC)
- Omaha, NE
- NPI 1063725554
-
- Federally Qualified Health Center (FQHC)
- Omaha, NE
- NPI 1164735759
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.