Individual provider Active NPI

Linda Miodonski, PA-C

  • Physician Assistant
  • Gretna, NE
National Provider Identifier
1366163453
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2943 Issued in NE
Practice address
102 W Gruenther Rd
Gretna, NE 68028-4828
Phone
(402) 332-2772
NPI assigned
Sep 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 120540 IA
Physician Assistant 363A00000X 2943 NE Primary

Addresses

Primary practice location

102 W Gruenther Rd
Gretna, NE 68028-4828

Mailing address

7261 Mercy Rd
Omaha, NE 68124-2311

Other practice location 1

3135 W Broadway
Council Bluffs, IA 51501-3359
Phone (712) 328-9100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230829000870 NE Practitioner - Physician Assistant 3678936366 Reassigns benefits to 1 organization
I20230829000941 IA Practitioner - Physician Assistant 3678936366 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians

Practice addresses (Care Compare)

16101 Evans St
Omaha, NE 68116-6447
Phone (402) 717-9700

1625 N 205TH St
CHI Health Clinic
Elkhorn, NE 68022-4759
Phone (402) 758-5452

16909 Lakeside Hills CT
Omaha, NE 68130-4661

5045 S 153Rd St
Omaha, NE 68137-5001
Phone (402) 717-9100

6801 Newport Ave
Omaha, NE 68152-2152
Phone (402) 572-3900

8141 W Ctr
Omaha, NE 68124-3273
Phone (402) 717-3000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic CurrentSince Sep 19, 2023 Accepting new patients
Alegent Creighton Clinic CurrentSince Sep 19, 2023 Accepting new patients
Alegent Creighton Clinic CurrentSince Sep 19, 2023 Accepting new patients
Alegent Creighton Clinic Physician Assistant Past Accepting new patients

Locations

3135 W Broadway
Council Bluffs, IA 51501
Phone (712) 242-2040

800 Mercy Dr
Ste 220
Council Bluffs, IA 51503
Phone (712) 388-2660

2771 Solution Ctr
Chicago, IL 60677

102 W Gruenther Rd
Gretna, NE 68028
Phone (402) 332-2772

7261 Mercy Rd
Omaha, NE 68124
Phone (402) 398-6248

16909 Lakeside Hills Ct
Ste 401
Omaha, NE 68130
Phone (402) 827-4920

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.

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": "1662508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1366163453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7261 MERCY RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W GRUENTHER RD",
            "city": "GRETNA",
            "state": "NE",
            "postal_code": "680284828",
            "telephone_number": "402-332-2772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3135 W Broadway",
            "address_purpose": "LOCATION",
            "city": "Council Bluffs",
            "state": "IA",
            "postal_code": "515013359",
            "country_code": "US",
            "telephone_number": "712-328-9100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIODONSKI",
        "first_name": "LINDA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-07",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "120540",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "2943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gretna, NE

Sources for this page

Verify at the official NPI Registry.