Elliot David Blue, MD
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Omaha, NE
NPI 1376168534 · NPPES record last updated Jun 16, 2022
Key facts
- NPI
- 1376168534
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- License
- 9335 (NE)
- Practice address
- 982055 Nebraska Medical Ctr
Omaha, NE 68198-2055 - Phone
- (402) 559-7738
- NPI assigned
- Jun 13, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 25
Medicare Care Compare profile
- Specialty
- Hospitalist
- Education
- Sanford School of Medicine of University of South Dakota, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Avera McKennan
Practice addresses (Care Compare)
1325 S Cliff Ave
Sioux Falls, SD 57105-1007
300 W 5TH St
Miller, SD 57362-1238
Phone (605) 853-0158
901 E Virgil Ave
Milbank, SD 57252-2124
Phone (605) 432-4538
Hospital & facility affiliations
- Avera McKennan Hospital & University Health Center
- Avera Merrill Pioneer Hospital
- Floyd Valley Healthcare
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241024001353 | SD | Practitioner - Hospitalist |
0143643072 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11881 | GA | MD | Internal Medicine Physician |
| 9335 | NE | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Avera McKennan | Current | Accepting new patients | |
| Avera McKennan | Current |
Accepting new patients | |
| Avera McKennan | Current |
Accepting new patients | |
| August University - Medical College of Georgia | Internal Medicine | Past |
Accepting new patients |
| Avera McKennan | Past | Accepting new patients |
Locations
300 W 5th St
Miller, SD 57362
Phone (605) 853-0158
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 11881 | GA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | 9335 | NE | Yes |
Addresses
Primary practice location
982055 Nebraska Medical Ctr
Omaha, NE 68198-2055
Mailing address
982055 Nebraska Medical Ctr
Omaha, NE 68198-2055
Phone (402) 559-7738
Other providers in Omaha, NE
- Blue Oasis Transportation Corporation
- Blue Sky Counseling LLC
- Blue Sky Dental LLC
- Cara Blue
- Elizabeth Ann Blue
- Joseph Blue
- Mason Juel Blue
- Bluemoon Home Care Services LLC
- Bluemountain Home Care Services LLC
- Deandre Bluitt
All providers in Omaha, NE · Student in an Organized Health Care Education/Training Program in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2022. 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.