Individual provider Active NPI

Mikayla Reeves, PA-C

  • Trauma Surgery Physician
  • Omaha, NE
National Provider Identifier
1417819715
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
3335 Issued in NE
Practice address
4242 Farnam St
Omaha, NE 68131-2806
Phone
(402) 552-2000
NPI assigned
Nov 25, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Trauma Surgery Physician 2086S0127X 3335 NE Primary

Addresses

Primary practice location

4242 Farnam St
Omaha, NE 68131-2806

Mailing address

112 E Sloup Dr
Wahoo, NE 68066-2519
Phone (402) 443-6658

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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 1

Enrollment IDStateProvider typePAC IDDetails
I20260122000925 NE Practitioner - Physician Assistant 9436636305 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unmc PhysiciansGroup PAC ID 6002728391, 1,490 clinicians

Practice addresses (Care Compare)

4014 Leavenworth St
Omaha, NE 68105-1053
Phone (402) 552-7928

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3335NEMDTrauma Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unmc Physicians CurrentSince Dec 23, 2025 Accepting new patients

Locations

Emile 42nd St
Omaha, NE 68198
Phone (402) 552-6731

4242 Farnam St
Omaha, NE 68131
Phone (402) 552-6094

Organizations & group practices 1

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 2

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": "1764028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1417819715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 E SLOUP DR",
            "city": "WAHOO",
            "state": "NE",
            "postal_code": "680662519",
            "telephone_number": "402-443-6658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4242 FARNAM ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312806",
            "telephone_number": "402-552-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEVES",
        "first_name": "MIKAYLA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-25",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "NE",
            "license": "3335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.