Individual provider Active NPI

Traci Wilkinson, PAC

  • Physician Assistant
  • Omaha, NE
National Provider Identifier
1376560862
Registry record updated Nov 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
NE1019 Issued in NE
Practice address
9850 Nicholas Street, Suite 250
Omaha Thoracic & Cardiovascular Surgery, P.C.
Omaha, NE 68114-2191
Phone
(402) 399-9990
Fax
(402) 399-9851
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NE1019 NE Primary

Addresses

Primary practice location

9850 Nicholas Street, Suite 250
Omaha Thoracic & Cardiovascular Surgery, P.C.
Omaha, NE 68114-2191

Mailing address

9850 Nicholas Street, Suite 250
Omaha Thoracic & Cardiovasculary Surgery, PC
Omaha, NE 68114-2191
Phone (402) 399-9990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 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
I20040609001163 NE Practitioner - Physician Assistant 7719960947 Reassigns benefits to 1 organization
I20110721000689 IA Practitioner - Physician Assistant 7719960947 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
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)

10060 Regency Cir
Omaha, NE 68114-3732
Phone (402) 354-1570

8303 Dodge St
Omaha, NE 68114-4108
Phone (402) 354-8163

Hospital & facility affiliations

  • The Nebraska Methodist Hospital Hospital, Omaha, NE, CCN 280040

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1019NEMDPhysical Therapy Assistant
NE1019NEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Clinic Inc Physician Assistant CurrentSince Jan 1, 2021 Accepting new patients
Nebraska Methodist Hospital Current Accepting new patients
Watz Surgical Group LLC Past Accepting new patients
Deanna Armstrong MD PC Past Accepting new patients
Midwest Surgical Associates PC Past Accepting new patients
General & Vascular Surgery, P.C. PastSince Jun 15, 1997 Accepting new patients

Locations

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

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

2800 N 83rd St
Ste E
Lincoln, NE 68507
Phone (402) 413-6363

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

825 S 169th St
Fl 3
Omaha, NE 68118
Phone (402) 354-5451

1120 N 103rd Plz
Ste 102
Omaha, NE 68114
Phone (402) 354-0120

8303 W Dodge Rd
Omaha, NE 68114
Phone (402) 354-4000

1120 N 103rd Plz
Ste 200
Omaha, NE 68114
Phone (402) 354-0400

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

Interoperability endpoints

  • Direct secure messaging: traci.wilkinson@direct.nmhs.org

Organizations & group practices 6

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 1

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352332800000",
    "number": "1376560862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9850 NICHOLAS STREET, SUITE 250",
            "address_2": "OMAHA THORACIC & CARDIOVASCULARY SURGERY, PC",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681142191",
            "telephone_number": "402-399-9990",
            "fax_number": "402-399-9851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9850 NICHOLAS STREET, SUITE 250",
            "address_2": "OMAHA THORACIC & CARDIOVASCULAR SURGERY, P.C.",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681142191",
            "telephone_number": "402-399-9990",
            "fax_number": "402-399-9851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINSON",
        "first_name": "TRACI",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2012-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "NE1019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.