NPIMap

Individual provider Active NPI

Bradley Wayne Nielsen, PA-C

  • Physician Assistant
  • Omaha, NE
National Provider Identifier
1346661436
Registry record updated Oct 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1782 Issued in NE
Practice address
4242 Farnam St Ste 550
Omaha, NE 68131-2813
Phone
(402) 836-9900
NPI assigned
Dec 17, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1782 NE
Medical Physician Assistant 363AM0700X 002471 IA
Physician Assistant 363A00000X 1782 NE Primary

Addresses

Primary practice location

4242 Farnam St Ste 550
Omaha, NE 68131-2813

Mailing address

988102 Nebraska Medical Ctr
Omaha, NE 68198-8102

Other practice location 1

801 Harmony St
Suite 202
Council Bluffs, IA 51503-3106
Phone (712) 308-1563

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
I20141030001018 NE Practitioner - Physician Assistant 2769612266 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
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)

4242 Farnam St
Omaha, NE 68131-2813

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
  • Great Plains Health Hospital, North Platte, NE, CCN 280065
  • Bellevue Medical Center Hospital, Bellevue, NE, CCN 280132
  • Gothenburg Health Hospital, Gothenburg, NE, CCN 281313
  • Grand Island Regional Medical Center Hospital, Grand Island, NE, CCN 280139

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1782NEMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Health Immanuel Medical Center Past Accepting new patients
Haysam Akkad, MD, PC Physician Assistant Past Accepting new patients
Farid Sadr, P.C. Past Accepting new patients
Premier Urgent Care/Family Care of Nebraska LLC PastSince Jul 1, 2015 Accepting new patients
Urgent Care Group LLC Past Accepting new patients

Organizations & group practices 7

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": "1387238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601856000000",
    "number": "1346661436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988102 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681988102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4242 FARNAM ST STE 550",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312813",
            "telephone_number": "402-836-9900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Harmony St",
            "address_2": "Suite 202",
            "address_purpose": "LOCATION",
            "city": "Council Bluffs",
            "state": "IA",
            "postal_code": "515033106",
            "country_code": "US",
            "telephone_number": "712-308-1563",
            "fax_number": "712-388-2723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "BRADLEY",
        "middle_name": "WAYNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-17",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "1782",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IA",
            "license": "002471",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.