First Care Medical, PC
Organization Active NPI Clinic/Center · Kearney, NE
NPI 1295834968 · NPPES record last updated Sep 10, 2015
Key facts
- NPI
- 1295834968
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- FIRST CARE MEDICAL, PC
- Practice address
- 2605 2ND Ave
Kearney, NE 68847-4425 - Phone
- (308) 236-7016
- Fax
- (308) 236-7027
- NPI assigned
- Sep 21, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Aaron J Madsen, MBA, ATC, NREMT
- Title
- Clinic Administrator
- Phone
- (308) 236-7016
Other NPIs on the same Medicare enrollment 1
Subparts reporting this organization as parent 1
Practitioners 8
-
David Lynn Blauvelt, PA-C
-
Mackenzie C Boyer, PA-C
-
Gerald E Matzke Jr., M.D.
-
Paul R Mueting, P.A.
-
Jessie Lea Olesen, FNP
-
Samantha Sue Young, APRN
-
Aaron Jeffrey Madsen, MBA, ATC, LAT, NREMT
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 28D1035931 | First Care Medical PC | Compliance | Jul 27, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NE
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090220000551 | NE | Part B Supplier - Clinic/Group Practice | 6305901513 |
Receives reassigned benefits from 7 practitioners 1 other NPI on this enrollment Practice locations: Kearney, NE |
National Provider Directory
Locations
104 W Seneca St
Ravenna, NE 68869
Phone (308) 236-7016
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Yes |
Addresses
Primary practice location
2605 2ND Ave
Kearney, NE 68847-4425
Mailing address
2605 2ND Ave
Kearney, NE 68847-4425
Phone (308) 236-7016
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100252333-00 | Medicaid | NE | |
| DP1168 | Other | NE | RAILROAD MEDICARE PTAN |
| 28D1035931 | Other | NE | CLIA ID # |
| NA1259 | Other | NE | MEDICARE PTAN |
Other names
- First Care Medical, PC of Kearney
Other providers in Kearney, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.