Individual provider Active NPI

Cody Allen Sasek, PHD, PA-C, ATC

  • Physician Assistant
  • Omaha, NE
National Provider Identifier
1417283045
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2412 Cuming St
Omaha, NE 68131-1601
Phone
(402) 641-7278
NPI assigned
Nov 2, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2412 Cuming St
Omaha, NE 68131-1601

Mailing address

1611 N 52ND St
Omaha, NE 68104-5014
Phone (402) 641-7278

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, NE2 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
I20100608000637 KS Practitioner - Physician Assistant 2466582069 Reassigns benefits to 1 organization
I20160202002194 NE Practitioner - Physician Assistant 2466582069 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1800NEMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic CurrentSince Aug 31, 2023 Accepting new patients
Alegent Creighton Clinic Physician Assistant Past Accepting new patients

Locations

2771 Solution Ctr
Chicago, IL 60677

16901 Lakeside Hills Ct
Omaha, NE 68130
Phone (402) 572-6500

16909 Lakeside Hills Ct
Ste 401
Omaha, NE 68130
Phone (402) 827-4920

2412 Cuming St
Omaha, NE 68131
Phone (402) 449-4000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1257120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1417283045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 N 52ND ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681045014",
            "telephone_number": "402-641-7278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2412 CUMING ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681311601",
            "telephone_number": "402-641-7278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SASEK",
        "first_name": "CODY",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "PHD, PA-C, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-02",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.