Crystal Vinas, AGPNP
Individual provider Active NPI Adult Health Nurse Practitioner · Omaha, NE
NPI 1376019885 · NPPES record last updated Nov 21, 2024
Key facts
- NPI
- 1376019885
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- 113369 (NE)
- Practice address
- 12050 Pacific St
Omaha, NE 68154-3507 - Phone
- (402) 614-4969
- NPI assigned
- Oct 23, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Montgomery County Memorial Hospital
Practice addresses (Care Compare)
2301 Eastern Ave
Red Oak, IA 51566-1300
Phone (712) 623-7000
Hospital & facility affiliations
- Montgomery County Memorial Hospital
- Montgomery County Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200401002679 | IA | Practitioner - Nurse Practitioner | 3577992221 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 113369 | NE | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Montgomery County Memorial Hospital | Current | Accepting new patients | |
| Montgomery County Memorial Hospital | Current |
Accepting new patients | |
| Montgomery County Memorial Hospital | Current |
Accepting new patients | |
| LMMC Lincoln, LLC | Past | Accepting new patients | |
| LMMC LLC | Past |
Accepting new patients |
Locations
2301 Eastern Ave
Red Oak, IA 51566
Phone (712) 623-7270
Interoperability endpoints
- mccvinas@mcmh.cernerdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 113369 | NE | Yes |
Addresses
Primary practice location
12050 Pacific St
Omaha, NE 68154-3507
Mailing address
12050 Pacific St
Omaha, NE 68154-3507
Phone (402) 614-4969
Other providers in Omaha, NE
- Emmanuel Villezcas
- Laura Villotta
- Tessa Louise Villotta
- Ryan Lyle Villwok
- Mirlyne Vilmar
- Chadwicxk Robert Vincent
- Elizabeth Vincent
- Grace Kathryn Vincent
- Scott Allen Vincent
- Christine Vincentini
All providers in Omaha, NE · Adult Health Nurse Practitioner in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 21, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.