Individual provider Active NPI

Megan O Bryan Raabe, P.A.-C

  • Medical Physician Assistant
  • Lincoln, NE
National Provider Identifier
1366544678
Registry record updated Apr 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
918 Issued in NE
Practice address
2331 Fairfield St
Suite 1
Lincoln, NE 68521-1348
Phone
(402) 434-7177
Fax
(402) 434-7180
NPI assigned
Sep 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2014

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 918 NE Primary

Addresses

Primary practice location

2331 Fairfield St
Suite 1
Lincoln, NE 68521-1348

Mailing address

2331 Fairfield St
Suite 1
Lincoln, NE 68521-1348
Phone (402) 434-7177

Other identifiers 2

IdentifierTypeStateIssuer
47069726000MedicaidNE
47069726017MedicaidNE

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140619001647 NE Practitioner - Physician Assistant 5496854606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nebraska Urban Indian Health Coalition, Inc.Group PAC ID 9436183902, 6 clinicians

Practice addresses (Care Compare)

2231 Fairfield St
Suite 1
Lincoln, NE 68521-1348
Phone (402) 434-7177

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
918NEMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Morningstar Counseling and Consultation PC PastSince Nov 1, 2024 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.

NPI Registry JSON

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396310400000",
    "number": "1366544678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2331 FAIRFIELD ST",
            "address_2": "SUITE 1",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685211348",
            "telephone_number": "402-434-7177",
            "fax_number": "402-434-7180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2331 FAIRFIELD ST",
            "address_2": "SUITE 1",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685211348",
            "telephone_number": "402-434-7177",
            "fax_number": "402-434-7180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAABE",
        "first_name": "MEGAN",
        "middle_name": "O BRYAN",
        "name_prefix": "Mrs.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-05",
        "last_updated": "2014-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47069726000",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47069726017",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.