Active NPI
Madonna Rehabilitation Hospital
- Physical Medicine & Rehabilitation Physician
- Lincoln, NE
National Provider Identifier
1417045642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- Legal business name
- MADONNA REHABILITATION HOSPITAL
- Practice address
- 5401 South St
Lincoln, NE 68506-2150 - Phone
- (402) 413-3000
- Fax
- (402) 413-4113
- NPI assigned
- Oct 11, 2006
- Organization subpart
- Yes
- Parent organization
- MADONNA REHABILITATION HOSPITAL
Authorized official
NPPES NPI Registry- Name
- Mr. Paul A Dongilli Jr.
- Title
- President & Ceo
- Phone
- (402) 413-3000
Other NPIs with the same Medicare PAC ID 5
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Practitioners 223
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physical Medicine & Rehabilitation Physician
- Omaha, NE
- NPI 1134282221
NE, Physical Medicine & Rehabilitation
-
- Physical Medicine & Rehabilitation Physician
- Omaha, NE
- NPI 1417918707
NE, Physical Medicine & Rehabilitation
-
- Critical Care Medicine Nurse Practitioner
- Omaha, NE
- NPI 1407552896
NE
-
- Physical Medicine & Rehabilitation Physician
- Omaha, NE
- NPI 1972998516
NE, Physical Medicine & Rehabilitation
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE, FL, NC, LA
Medicare enrollment records 4
Medicare enrollment files| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031118000079 | NE | Part B Supplier - Clinic/Group Practice | 0446164081 |
Receives reassigned benefits from 170 practitioners Practice locations: Lincoln, NE |
| O20260120004115 | FL | Part B Supplier - Clinic/Group Practice | 0446164081 |
Receives reassigned benefits from 1 practitioner Practice locations: Gotha, FL |
| O20260128001999 | NC | Part B Supplier - Clinic/Group Practice | 0446164081 |
Receives reassigned benefits from 1 practitioner Practice locations: Charlotte, NC |
| O20260305002161 | LA | Part B Supplier - Clinic/Group Practice | 0446164081 |
Receives reassigned benefits from 1 practitioner Practice locations: Calhoun, LA |
National Provider Directory
National Provider Directory- Part of
- Madonna Rehabilitation Hospital
Locations
2300 S 16th St
Lincoln, NE 68502
Phone (402) 434-6042
202 N 175th Plz
Omaha, NE 68118
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
5401 South St
Lincoln, NE 68506-2150
Mailing address
5401 South St
Lincoln, NE 68506-2150
Phone (402) 413-3000
Other identifiers 5
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500885900 | Other | MO | MEDICAID |
| D0287 | Other | RAILROAD MEDICARE | |
| 0982017 | Other | IA | MEDICAID |
| 100187780D | Other | KS | MEDICAID |
| 7729 | Other | NE | BLUE CROSS |
Other names 1
NPPES NPI Registry- Rehabilitation Specialists
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 10, 2019.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1568073600000",
"number": "1417045642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5401 SOUTH ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685062150",
"telephone_number": "402-413-3000",
"fax_number": "402-413-4113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5401 SOUTH ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685062150",
"telephone_number": "402-413-3000",
"fax_number": "402-413-4113"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MADONNA REHABILITATION HOSPITAL",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "MADONNA REHABILITATION HOSPITAL",
"enumeration_date": "2006-10-11",
"last_updated": "2019-09-10",
"status": "A",
"authorized_official_last_name": "DONGILLI",
"authorized_official_first_name": "PAUL",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "PRESIDENT & CEO",
"authorized_official_telephone_number": "402-413-3000",
"authorized_official_name_prefix": "Mr.",
"authorized_official_name_suffix": "Jr."
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Medicine & Rehabilitation",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID",
"identifier": "500885900",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "D0287",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID",
"identifier": "0982017",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID",
"identifier": "100187780D",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "7729",
"state": "NE"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Rehabilitation Specialists",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Rehabilitation Specialists",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.