Georgetown Medical, PC

Primary specialty

ContractorTaxonomy code 171W00000X

License

218816123 Issued in NE

Legal business name

GEORGETOWN MEDICAL, PC

Doing business as

Georgetown Medical, P.C.

Practice address

3440 S 50TH St
Omaha, NE 68106-3829

Phone

(402) 556-3000

Fax

(402) 991-7115

NPI assigned

Feb 20, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

George Stanley Hutfless, MDNPI 1891765004

Title

Owner/Physician

Phone

(402) 556-3000

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Georgetown Medical, P.C. Doing business as

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• George Stanley Hutfless, M.D.

  • Internal Medicine Physician
  • Omaha, NE
  • NPI 1891765004
  Medicare reassignment Authorized official
• Mary Ann Hutfless, R.PH.

  • Pharmacist
  • Omaha, NE
  • NPI 1396805628
  NPD

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

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1376518837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3440 S 50TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681063829",
            "telephone_number": "402-556-3000",
            "fax_number": "402-991-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 S 50TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681063829",
            "telephone_number": "402-556-3000",
            "fax_number": "402-991-7115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGETOWN MEDICAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-20",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "HUTFLESS",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "STANLEY",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "402-556-3000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Contractor",
            "state": "NE",
            "license": "218816123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2801-1204",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LIC.#  G. HUTFLESS",
            "identifier": "18358",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGE HUTFLESS,MD  NPI #",
            "identifier": "1891765004",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2801-18358",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2965301",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGE HUTFLESS S.SEC. #",
            "identifier": "508741492",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Georgetown Medical, P.C.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Georgetown Medical, P.C.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ryan A George
• Serena George
• Trellnequa George
• Brie Georger, OTR/L
• Corey Georgesen, M.D.
• Andrew Georgi
• Alexander Oleg Georgiev, MD
• Alysa Georgopoulos
• Lazara Gerabel Landa
• Jenny Geracci, MD

• Contractor in Omaha, NE
• Providers in Omaha, NE by specialty
• Contractor in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.