Individual provider Active NPI

Mara P Paradis, M.D.

  • Pediatrics Physician
  • Omaha, NE
National Provider Identifier
1275697443
Registry record updated Feb 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
22293 Issued in NE
Practice address
16929 Frances St
Ste 101
Omaha, NE 68130-4683
Phone
(402) 758-5125
Fax
(402) 758-5283
NPI assigned
Dec 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 22293 NE Primary

Addresses

Primary practice location

16929 Frances St
Ste 101
Omaha, NE 68130-4683

Mailing address

555 N 30TH St
Omaha, NE 68131-2136
Phone (402) 280-8100

Other identifiers 2

IdentifierTypeStateIssuer
05953OtherNEBCBS OF NE
250654OtherNEMIDLANDS CHOICE

Other names 1

  • Dr. Mara P Chadwick 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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100512000204 NE Practitioner - Pediatric Medicine 6103954136 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22293NEMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Father Flanagan'S Boys' Home Pediatrics CurrentSince Mar 8, 2010 Accepting new patients
Alegent Creighton Health Past Accepting new patients
Father Flanagan'S Boys' Home Past Accepting new patients
Father Flanagan'S Boys Home Past Accepting new patients

Locations

14080 Boys Town Hospital Rd
Boys Town, NE 68010
Phone (402) 778-6900

16929 Frances St
Omaha, NE 68130
Phone (531) 355-3358

6715 S 180th St
Omaha, NE 68135
Phone (531) 355-2300

7205 W Center Rd
Ste 104
Omaha, NE 68124
Phone (402) 392-7684

16929 Frances St
Ste 101
Omaha, NE 68130
Phone (402) 758-5125

555 N 30th St
Omaha, NE 68131
Phone (402) 280-8100

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360713600000",
    "number": "1275697443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 N 30TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312136",
            "telephone_number": "402-280-8100",
            "fax_number": "402-280-8103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16929 FRANCES ST",
            "address_2": "STE 101",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681304683",
            "telephone_number": "402-758-5125",
            "fax_number": "402-758-5283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARADIS",
        "first_name": "MARA",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2013-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "22293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NE",
            "identifier": "05953",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "250654",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARA",
            "last_name": "CHADWICK",
            "middle_name": "P",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.