Individual provider Active NPI

Anna Skorupa, APRN

  • Family Nurse Practitioner
  • Omaha, NE
National Provider Identifier
1306276316
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
115005 Issued in NE
Practice address
4920 S 30TH St Ste 103
Omaha, NE 68107-1656
Phone
(402) 734-4110
Fax
(402) 734-3990
NPI assigned
Nov 13, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2013038960 MO
Family Nurse Practitioner 363LF0000X C5051016 OK
Family Nurse Practitioner 363LF0000X 115005 NE Primary

Addresses

Primary practice location

4920 S 30TH St Ste 103
Omaha, NE 68107-1656

Mailing address

4920 S 30TH St Ste 103
Omaha, NE 68107-1656
Phone (402) 734-4110

Other identifiers 1

IdentifierTypeStateIssuer
200579180AMedicaidOK

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231214002466 NE Practitioner - Nurse Practitioner 5799915179 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2207 Georgia Ave
Bellevue, NE 68005-4524
Phone (402) 502-8855

4101 S 120TH St
Omaha, NE 68137-1250
Phone (402) 505-3907

4920 S 30TH St
Omaha, NE 68107-1656
Phone (402) 734-4110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2013038960MOMDFamily Nurse Practitioner
115005NEMDFamily Nurse Practitioner
C5051016OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oneworld Community Health Centers, Inc. CurrentSince Nov 11, 2023 Accepting new patients
Oneworld Community Health Centers, Inc. CurrentSince Nov 11, 2023 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

4700 Giles Rd
Omaha, NE 68157
Phone (402) 991-3904

3121 U St
Omaha, NE 68107
Phone (402) 933-4968

4215 S 20th St
Omaha, NE 68107
Phone (402) 734-1833

2520 S 130th Ave
Omaha, NE 68144
Phone (402) 769-7077

2021 Saint Marys Ave
Omaha, NE 68102
Phone (402) 505-8180

4920 S 30th St
Ste 103
Omaha, NE 68107

5616 L St
Omaha, NE 68117
Phone (402) 881-2743

4101 S 120th St
Omaha, NE 68137
Phone (402) 505-3907

4310 S 24th St
Omaha, NE 68107
Phone (402) 502-8841

4229 N 90th St
Omaha, NE 68134
Phone (402) 401-6000

2723 Q St
Omaha, NE 68107
Phone (402) 715-5440

122 S 6th St
Plattsmouth, NE 68048
Phone (402) 296-2345

Interoperability endpoints

  • Direct secure messaging: annie.skorupa.p1@direct.oneworldomaha.nextgenshare.com

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": "1384300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1306276316",
    "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",
            "fax_number": "402-734-3990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4920 S 30TH ST STE 103",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681071656",
            "telephone_number": "402-734-4110",
            "fax_number": "402-734-3990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKORUPA",
        "first_name": "ANNA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-13",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2013038960",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "C5051016",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "115005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200579180A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.