Individual provider Active NPI

Corey Georgesen, M.D.

  • Dermatology Physician
  • Omaha, NE
National Provider Identifier
1447660436
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
32546 Issued in NE
Practice address
4014 Leavenworth St
Omaha, NE 68105-1053
Phone
(402) 552-7928
NPI assigned
Apr 30, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 32546 NE Primary

Addresses

Primary practice location

4014 Leavenworth St
Omaha, NE 68105-1053

Mailing address

988102 Nebraska Medical Ctr
Omaha, NE 68198-8102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NE2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180815002928 PA Practitioner - Dermatology 9638428287 Reassigns benefits to 1 organization
I20200828000774 NE Practitioner - Dermatology 9638428287 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Nebraska College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions300
Removal of nail tissue1-10
Removal or shaving of skin growth49
Skin biopsy63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians CurrentSince Aug 1, 2018 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients
University of Pittsburgh Physicians Dermatology CurrentSince Aug 1, 2018 Accepting new patients
Unmc Physicians CurrentSince Sep 1, 2020 Accepting new patients

Locations

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

17405 Burke St
Ste 10170
Omaha, NE 68118

988102 Nebraska Medical Ctr
Omaha, NE 68198
Phone (402) 559-5600

3600 Forbes Ave
Ste 140
Pittsburgh, PA 15213

3601 5th Ave
Ste 5A
Pittsburgh, PA 15213
Phone (412) 647-4200

3708 5th Ave
Ste 500
Pittsburgh, PA 15213
Phone (412) 383-1800

Interoperability endpoints

  • Direct secure messaging: cgeorgesen36366@direct.nebraskamed.com

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1398816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1447660436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988102 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681988102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4014 LEAVENWORTH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681051053",
            "telephone_number": "402-552-7928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGESEN",
        "first_name": "COREY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-30",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NE",
            "license": "32546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.