Individual provider Active NPI

Pauline Song Seymour, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Council Bluffs, IA
National Provider Identifier
1437447612
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
351 Issued in NE
Practice address
1707 Oak Park Rd
Council Bluffs, IA 51503-1361
Phone
(402) 658-9681
NPI assigned
Jul 21, 2011
Last updated
Aug 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 073779 IA
Foot & Ankle Surgery Podiatrist 213ES0103X 351 NE Primary

Addresses

Primary practice location

1707 Oak Park Rd
Council Bluffs, IA 51503-1361

Mailing address

1707 Oak Park Rd
Council Bluffs, IA 51503-1361
Phone (402) 658-9681

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220705001136 NE Practitioner - Podiatry 5193942936 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Giaimo Podiatry of Nebraska LLCGroup PAC ID 9931495645, 3 clinicians

Practice addresses (Care Compare)

233 S 13TH St
Suite 1900
Lincoln, NE 68508-2000
Phone (248) 528-2116

Merit-based Incentive Payment System (MIPS)

Final score
89.57 of 100Reported as group
Quality
62.85
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue2700
Removal or shaving of skin growth586
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nebraska Lower Extremity Surgery Group, LLC Foot & Ankle Surgery CurrentSince Jun 1, 2022 Accepting new patients
Nebraska Lower Extremity Surgery Group, LLC Foot & Ankle Surgery CurrentSince Jun 1, 2022 Accepting new patients
Giaimo Podiatry of Nebraska LLC CurrentSince Aug 23, 2024 Accepting new patients
Edward N Prikaszczikow Past Accepting new patients

Locations

12910 Shelbyville Rd
Ste 300
Louisville, KY 40243
Phone (502) 214-0693

2705 Samson Way
Bellevue, NE 68123
Phone (402) 331-6387

414 N Willson St
Blue Hill, NE 68930
Phone (402) 705-9908

233 S 13th St
Ste 1900
Lincoln, NE 68508

1301 N 72nd St
Omaha, NE 68114
Phone (402) 393-1741

18010 R Plz
Ste 106
Omaha, NE 68135
Phone (402) 991-8999

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1311206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1437447612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1707 OAK PARK RD",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515031361",
            "telephone_number": "402-658-9681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 OAK PARK RD",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515031361",
            "telephone_number": "402-658-9681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEYMOUR",
        "first_name": "PAULINE",
        "middle_name": "SONG",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-21",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IA",
            "license": "073779",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NE",
            "license": "351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

Verify at the official NPI Registry.