Individual provider Active NPI

Shaun C Horak, PA-C

  • Surgical Physician Assistant
  • Elkhorn, NE
National Provider Identifier
1457330748
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
1348 Issued in NE
Practice address
222 N 192ND St
Elkhorn, NE 68022-5363
Phone
(402) 390-4111
Fax
(402) 390-4115
NPI assigned
Jan 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9880 MN
Surgical Physician Assistant 363AS0400X 1348 NE Primary
Physician Assistant 363A00000X 1348 NE

Addresses

Primary practice location

222 N 192ND St
Elkhorn, NE 68022-5363

Mailing address

8005 Farnam Dr Ste 305
Omaha, NE 68114-3426
Phone (402) 390-4111

Other identifiers 2

IdentifierTypeStateIssuer
47068731751MedicaidNE
47068731742MedicaidNE

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
I20071219000416 NE Practitioner - Physician Assistant 6406833714 Reassigns benefits to 1 organization
I20210401002167 IA Practitioner - Physician Assistant 6406833714 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MD West One PCGroup PAC ID 0446228852, 89 clinicians

Practice addresses (Care Compare)

8005 Farnam Dr
Suite 305
Omaha, NE 68114-3426
Phone (402) 390-4111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.57 of 100Reported as group
Quality
76.1
Promoting interoperability
95
Improvement activities
40
Cost
76.63

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9880MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
MD West One, PC CurrentSince Mar 1, 2020 Accepting new patients
MD West One, PC Physician Assistant CurrentSince Mar 1, 2020 Accepting new patients
Nebraska Methodist Hospital Current Accepting new patients

Locations

1 Edmundson Pl
Ste 200
Council Bluffs, IA 51503
Phone (712) 243-3250

2959 US Highway 275
Hamburg, IA 51640
Phone 71238215158070

222 N 192nd St
Elkhorn, NE 68022

3301 E Elkhorn Dr
Ste 100
Fremont, NE 68025
Phone (402) 721-0090

16120 W Dodge Rd
Omaha, NE 68118
Phone (402) 354-0550

8005 Farnam Dr
Ste 305
Omaha, NE 68114

Interoperability endpoints

  • Direct secure messaging: shaun.horak@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 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": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1457330748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8005 FARNAM DR STE 305",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681143426",
            "telephone_number": "402-390-4111",
            "fax_number": "402-390-4115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 N 192ND ST",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680225363",
            "telephone_number": "402-390-4111",
            "fax_number": "402-390-4115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORAK",
        "first_name": "SHAUN",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9880",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NE",
            "license": "1348",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1348",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47068731751",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47068731742",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhorn, NE

Sources for this page

Verify at the official NPI Registry.