Individual provider Active NPI

Miles C Tommeraasen, M.D.

  • Surgery Physician
  • Lincoln, NE
National Provider Identifier
1295733905
Registry record updated Apr 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD-13478 Issued in IA
Practice address
2222 S 16TH St
200
Lincoln, NE 68502-3796
Phone
(402) 475-9090
Fax
(402) 475-9092
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X
Surgery Physician 208600000X MD-13478 IA Primary

Addresses

Primary practice location

2222 S 16TH St
200
Lincoln, NE 68502-3796

Mailing address

2222 S 16TH St
200
Lincoln, NE 68502-3796
Phone (402) 475-9090

Other identifiers 3

IdentifierTypeStateIssuer
34144OtherNEBCBS
020037780OtherRR MEDICARE
47077266413MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20160303001624 IA Practitioner - General Surgery 2062536873 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-13478IAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ottumwa Health Group LLC CurrentSince Feb 26, 2016 Accepting new patients
Ottumwa Health Group LLC CurrentSince Feb 26, 2016 Accepting new patients
East Morgan County Hospital Past Accepting new patients
Southeast Iowa Regional Medical Center, Inc. Past Accepting new patients

Locations

1001 Pennsylvania Ave
Ottumwa, IA 52501
Phone (641) 472-4111

Interoperability endpoints

  • Direct secure messaging: mtommeraasen@fmchosp.gwaydirect.com
  • Direct secure messaging: mtommeraasen113977@uihcdirect.org

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460678400000",
    "number": "1295733905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 S 16TH ST",
            "address_2": "200",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685023796",
            "telephone_number": "402-475-9090",
            "fax_number": "402-475-9092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 S 16TH ST",
            "address_2": "200",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685023796",
            "telephone_number": "402-475-9090",
            "fax_number": "402-475-9092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMMERAASEN",
        "first_name": "MILES",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2016-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IA",
            "license": "MD-13478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "34144",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "020037780",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47077266413",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.