Individual provider Active NPI

Melissa Ruth Hynek, APRN

  • Nurse Practitioner
  • Council Bluffs, IA
National Provider Identifier
1366770489
Registry record updated Jul 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F123448 Issued in IA
Practice address
201 Ridge St Ste 312
Council Bluffs, IA 51503-4643
Phone
(712) 396-7880
Fax
(712) 396-7885
NPI assigned
Dec 1, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 111083 NE
Women's Health Nurse Practitioner 363LW0102X F-123448 IA
Nurse Practitioner 363L00000X F123448 IA Primary

Addresses

Primary practice location

201 Ridge St Ste 312
Council Bluffs, IA 51503-4643

Mailing address

PO Box 3755
Omaha, NE 68103-0755
Phone (402) 354-2100

Other identifiers 3

IdentifierTypeStateIssuer
1366770489MedicaidIA
10026480117MedicaidNE
10026211300MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, NE2 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
I20100325000141 IA Practitioner - Nurse Practitioner 2567598915 Reassigns benefits to 1 organization
I20120127000951 NE Practitioner - Nurse Practitioner 2567598915 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Clinic IncGroup PAC ID 4880506062, 557 clinicians

Practice addresses (Care Compare)

201 Ridge St
Suite 312
Council Bluffs, IA 51503-4643
Phone (402) 354-1530

3353 L St
Omaha, NE 68107-2500
Phone (402) 354-7700

Hospital & facility affiliations

  • Methodist Jennie Edmundson Hospital, Council Bluffs, IA, CCN 160047
  • The Nebraska Methodist Hospital Hospital, Omaha, NE, CCN 280040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F123448IAMDNurse Practitioner
F-123448IAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Clinic Inc Nurse Practitioner CurrentSince Jul 1, 2019 Accepting new patients
Bluffs OBGYN and Incontinence Ctr Past Accepting new patients

Locations

800 Mercy Dr
#210
Council Bluffs, IA 51503
Phone (712) 388-2670

933 E Pierce St
Council Bluffs, IA 51503
Phone (712) 328-6000

1 Edmundson Pl
Council Bluffs, IA 51503
Phone (712) 396-4000

201 Ridge St
Ste 312
Council Bluffs, IA 51503
Phone (402) 815-1970

1 Edmundson Pl
Ste 310
Council Bluffs, IA 51503
Phone (712) 328-1801

825 S 169th St
Omaha, NE 68118
Phone (402) 354-3370

10060 Regency Cir
Omaha, NE 68114
Phone (402) 354-1405

3353 L St
Omaha, NE 68107
Phone (402) 354-7700

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": "1259625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1366770489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3755",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681030755",
            "telephone_number": "402-354-2100",
            "fax_number": "402-354-5451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 RIDGE ST STE 312",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515034643",
            "telephone_number": "712-396-7880",
            "fax_number": "712-396-7885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYNEK",
        "first_name": "MELISSA",
        "middle_name": "RUTH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-01",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NE",
            "license": "111083",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IA",
            "license": "F-123448",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "F123448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366770489",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026480117",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026211300",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

Verify at the official NPI Registry.