Individual provider Active NPI

Jeffrey Alan Passer, MD

  • Nephrology Physician
  • Omaha, NE
National Provider Identifier
1326057571
Registry record updated Nov 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
12482 Issued in NE
Practice address
10170 Nicholas St
Omaha, NE 68114-2174
Phone
(402) 391-3800
Fax
(402) 391-2422
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 12482 NE Primary

Addresses

Primary practice location

10170 Nicholas St
Omaha, NE 68114-2174

Mailing address

10170 Nicholas St
Omaha, NE 68114-2174
Phone (402) 391-3800

Other identifiers 3

IdentifierTypeStateIssuer
470626790OtherFED TAX ID
NA2227001OtherNEMEDICARE PTAN
47062679000MedicaidNE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040903000348 NE Practitioner - Internal MedicinePractitioner - Nephrology 2668448341 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10020 Nicholas St
Suite 105
Omaha, NE 68114-2188
Phone (402) 934-1660

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12482NEMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Nebraska Heart Institute PC Past Accepting new patients

Organizations & group practices 2

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 2

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448323200000",
    "number": "1326057571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10170 NICHOLAS ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681142174",
            "telephone_number": "402-391-3800",
            "fax_number": "402-391-2422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10170 NICHOLAS ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681142174",
            "telephone_number": "402-391-3800",
            "fax_number": "402-391-2422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASSER",
        "first_name": "JEFFREY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2015-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NE",
            "license": "12482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FED TAX ID",
            "identifier": "470626790",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "NA2227001",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47062679000",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.