Individual provider Active NPI

Jill R Selzle, PA

  • Physician Assistant
  • Omaha, NE
National Provider Identifier
1447295084
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1258 Issued in NE
Practice address
1120 N 103Rd PLZ Ste 200
Omaha, NE 68114-1119
Phone
(402) 354-0400
NPI assigned
Jun 18, 2006
Last updated
Jan 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2023

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 1258 NE Primary

Addresses

Primary practice location

1120 N 103Rd PLZ Ste 200
Omaha, NE 68114-1119

Mailing address

PO Box 3755
Omaha, NE 68103-0755
Phone (402) 354-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 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
I20060503000023 NE Practitioner - Physician Assistant 0143230326 Reassigns benefits to 2 organizations
I20221209001763 IA Practitioner - Physician Assistant 0143230326 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Clinic IncGroup PAC ID 4880506062, 557 clinicians

Practice addresses (Care Compare)

10060 Regency Cir
Omaha, NE 68114-3732
Phone (402) 354-1570

8303 Dodge St
Omaha, NE 68114-4108
Phone (402) 354-8163

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1258NEMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Nebraska Methodist Hospital Current Accepting new patients
Physicians Clinic Inc Physician Assistant CurrentSince Dec 31, 2022 Accepting new patients

Locations

1 Edmundson Pl
Council Bluffs, IA 51503
Phone (712) 396-4000

1 Edmundson Pl
Ste 310
Council Bluffs, IA 51503
Phone (712) 328-1801

10060 Regency Cir
Omaha, NE 68114
Phone (402) 354-1405

1120 N 103rd Plz
Ste 200
Omaha, NE 68114
Phone (402) 354-0400

Interoperability endpoints

  • Direct secure messaging: jill.selzle@direct.nmhs.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1447295084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3755",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681030755",
            "telephone_number": "402-354-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 N 103RD PLZ STE 200",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681141119",
            "telephone_number": "402-354-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELZLE",
        "first_name": "JILL",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-18",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.