NPIMap

Individual provider Active NPI

Mitzi T Infante Magana, PA-C

  • Medical Physician Assistant
  • Omaha, NE
National Provider Identifier
1306320916
Registry record updated Sep 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2280 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
Sep 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2280 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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181219000911 NE Practitioner - Physician Assistant 2860737822 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Unmc PhysiciansGroup PAC ID 6002728391, 1,490 clinicians

Practice addresses (Care Compare)

987400 Nebraska Medical Ctr
Unmc Physicians Nebraska Medical Center
Omaha, NE 68198-7400
Phone (402) 559-4000

Emile 42ND St
Omaha, NE 68198-0001
Phone (402) 559-4015

Hospital & facility affiliations

  • The Nebraska Medical Center Hospital, Omaha, NE, CCN 280013
  • Regional West Medical Center Hospital, Scottsbluff, NE, CCN 280061
  • Bellevue Medical Center Hospital, Bellevue, NE, CCN 280132
  • Bryan Medical Center Hospital, Lincoln, NE, CCN 280003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2280NEMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Oneworld Community Health Centers, Inc. Past Accepting new patients
Oneworld Community Health Centers, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mitzi.infantemagana.p1@direct.oneworldomaha.nextgenshare.com
  • Direct secure messaging: minfantemagana233439@direct.nebraskamed.com

Organizations & group practices 3

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1537315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1306320916",
    "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": "INFANTE MAGANA",
        "first_name": "MITZI",
        "middle_name": "T",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-19",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "2280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.