Individual provider Active NPI

Audrina Alexis Mullane, PH.D.

  • Clinical Neuropsychologist
  • Omaha, NE
National Provider Identifier
1275790461
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
1083 Issued in NE
Practice address
8901 W Dodge Rd Ste 210
Omaha, NE 68114-3321
Phone
(402) 354-3152
Fax
(402) 354-8720
NPI assigned
May 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 1083 NE Primary

Addresses

Primary practice location

8901 W Dodge Rd Ste 210
Omaha, NE 68114-3321

Mailing address

PO Box 3755
Omaha, NE 68103-0755
Phone (402) 354-2100

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220531002294 NE Practitioner - Clinical Psychologist 1052608338 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Clinic IncGroup PAC ID 4880506062, 557 clinicians

Practice addresses (Care Compare)

8901 W Dodge Rd
210 Methodist Physicians Clinic Neurology
Omaha, NE 68114-3321
Phone (402) 354-2000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2715ORMDPhysical Therapist
1083NEMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Unmc Physicians CurrentSince May 19, 2022 Accepting new patients
Physicians Clinic Inc CurrentSince Aug 11, 2025 Accepting new patients
Alegent Health Immanuel Medical Center PastSince Oct 1, 2023 Accepting new patients
Alegent Creighton Clinic Past Accepting new patients
Albany General Hospital Clinical Neuropsychologist PastSince Nov 1, 2020 Accepting new patients

Locations

4242 Farnam St
Ste 247
Omaha, NE 68131
Phone (402) 552-2300

10060 Regency Cir
Omaha, NE 68114
Phone (402) 354-1405

825 S 169th St
Omaha, NE 68118
Phone (402) 354-3370

8901 W Dodge Rd
Ste 210
Omaha, NE 68114
Phone (402) 354-2000

Emile 42nd St
Omaha, NE 68198
Phone (402) 552-6731

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1275790461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3755",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681030755",
            "telephone_number": "402-354-2100",
            "fax_number": "402-354-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 W DODGE RD STE 210",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681143321",
            "telephone_number": "402-354-3152",
            "fax_number": "402-354-8720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLANE",
        "first_name": "AUDRINA",
        "middle_name": "ALEXIS",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-16",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NE",
            "license": "1083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.