NPIMap

Individual provider Active NPI

Andrea D. Clement, PA

  • Physician Assistant
  • Hastings, NE
National Provider Identifier
1427033653
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
627 Issued in NE
Practice address
2115 N Kansas Ave Ste 103
Hastings, NE 68901-2615
Phone
(402) 463-6828
Fax
(402) 463-4767
NPI assigned
Dec 9, 2005
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 627 NE Primary

Addresses

Primary practice location

2115 N Kansas Ave Ste 103
Hastings, NE 68901-2615

Mailing address

2115 N Kansas Ave Ste 103
Hastings, NE 68901-2615
Phone (402) 463-6828

Other practice location 1

729 N Custer Ave
Grand Island, NE 68803-4311
Phone (308) 382-9266

Other practice location 2

638 N Webb Rd
Grand Island, NE 68803-4057
Phone (308) 675-3171

Other identifiers 1

IdentifierTypeStateIssuer
35441OtherNEBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040908001210 NE Practitioner - Physician Assistant 0446226674 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grand Island Radiology Associates PCGroup PAC ID 7719978261, 44 clinicians

Practice addresses (Care Compare)

3610 Richmond Cir
Suite 100
Grand Island, NE 68803-3910
Phone (308) 398-6400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
627NEMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Brodstone Memorial Hospital Physician Assistant CurrentSince Mar 26, 2021 Accepting new patients
Twin Rivers Urgent Care LLC CurrentSince Oct 26, 2020 Accepting new patients
Twin Rivers Urgent Care LLC CurrentSince Oct 26, 2020 Accepting new patients
Brodstone Memorial Hospital CurrentSince Mar 26, 2021 Accepting new patients
Allergy, Asthma & Immunology Associates P.C. Past Accepting new patients
5MD Convenient Care LLC Past Accepting new patients

Locations

720 N Webb Rd
Grand Island, NE 68803
Phone (308) 384-2500

3203 Osborne Dr W
Ste 101
Hastings, NE 68901
Phone (308) 384-2500

220 W Leota St
North Platte, NE 69101
Phone (308) 534-2268

520 E 10th St
Superior, NE 68978
Phone (402) 224-3344

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1427033653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 N KANSAS AVE STE 103",
            "city": "HASTINGS",
            "state": "NE",
            "postal_code": "689012615",
            "telephone_number": "402-463-6828",
            "fax_number": "402-463-4767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 N KANSAS AVE STE 103",
            "city": "HASTINGS",
            "state": "NE",
            "postal_code": "689012615",
            "telephone_number": "402-463-6828",
            "fax_number": "402-463-4767"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "729 N Custer Ave",
            "address_purpose": "LOCATION",
            "city": "Grand Island",
            "state": "NE",
            "postal_code": "688034311",
            "country_code": "US",
            "telephone_number": "308-382-9266",
            "fax_number": "308-382-5290",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "638 N Webb Rd",
            "address_purpose": "LOCATION",
            "city": "Grand Island",
            "state": "NE",
            "postal_code": "688034057",
            "country_code": "US",
            "telephone_number": "308-675-3171",
            "fax_number": "308-675-3174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLEMENT",
        "first_name": "ANDREA",
        "middle_name": "D.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-09",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "35441",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hastings, NE

Sources for this page

Verify at the official NPI Registry.