Individual provider Active NPI

Jesse Pandorf, JESSE PANDORF M.D.

  • Anesthesiology Physician
  • Kearney, NE
National Provider Identifier
1326296807
Registry record updated Jun 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
26131 Issued in NE
Practice address
10 E 31St St
Kearney, NE 68847-2926
Phone
(308) 865-7100
NPI assigned
Sep 8, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X N0340 TX
Anesthesiology Physician 207L00000X 26131 NE Primary

Addresses

Primary practice location

10 E 31St St
Kearney, NE 68847-2926

Mailing address

10 E 31St St
Kearney, NE 68847-2926
Phone (308) 865-7100

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
I20110816000326 NE Practitioner - Anesthesiology 6103095732 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Nebraska College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CHI Health Clinic Physician Enterprise-Anesthesia LLCGroup PAC ID 2264794569, 224 clinicians

Practice addresses (Care Compare)

10 E 31St St
CHI Health Good Samaritan
Kearney, NE 68847-2908
Phone (308) 865-7100

Hospital & facility affiliations

  • CHI Health Good Samaritan Hospital, Kearney, NE, CCN 280009

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N0340TXMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CHI Health Clinic Physician Enterprise-Anesthesia LLC Anesthesiology CurrentSince Sep 1, 2020 Accepting new patients
CHI Health Clinic Physician Enterprise-Anesthesia LLC Anesthesiology Past Accepting new patients

Locations

2620 W Faidley Ave
Grand Island, NE 68803
Phone (308) 382-6856

10 E 31st St
Kearney, NE 68847
Phone (308) 234-5520

7500 Mercy Rd
Ste 1355
Omaha, NE 68124
Phone (402) 717-4866

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": "1220832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308787200000",
    "number": "1326296807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 E 31ST ST",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688472926",
            "telephone_number": "308-865-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 E 31ST ST",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688472926",
            "telephone_number": "308-865-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANDORF",
        "first_name": "JESSE",
        "name_prefix": "Dr.",
        "credential": "JESSE PANDORF M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-08",
        "last_updated": "2011-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "N0340",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NE",
            "license": "26131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearney, NE

Sources for this page

Verify at the official NPI Registry.