Individual provider Active NPI

Thomas William Homan, PA-C

  • Physician Assistant
  • Council Bluffs, IA
National Provider Identifier
1457447013
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
756 Issued in NE
Practice address
20 Power Dr Ste 5
Council Bluffs, IA 51501-7701
Phone
(712) 309-3023
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 756 NE Primary
Physician Assistant 363A00000X 107710 IA

Addresses

Primary practice location

20 Power Dr Ste 5
Council Bluffs, IA 51501-7701

Mailing address

1610 Watson St
Fremont, NE 68025-2093
Phone (402) 721-0773

Other practice location 1

220 E 22nd St
Fremont, NE 68025-2093
Phone (402) 727-5500

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100805000837 NE Practitioner - Physician Assistant 4981737384 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
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

101 E Centennial Rd
Physicians Clinic Papillion
Papillion, NE 68046-2079
Phone (402) 354-7750

11946 Standing Stone Dr
Gretna, NE 68028-8094
Phone (402) 815-4500

1240 E 23Rd St
MPC Urgent Care Fremont
Fremont, NE 68025-2411
Phone (402) 815-7100

4932 S 202ND Ave
MPC North Streams
Omaha, NE 68135-3927
Phone (402) 815-7500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
756NEMDSocial Worker
107710IAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Fremont Health CurrentSince Oct 16, 2018 Accepting new patients
Nebraska Methodist Hospital Current Accepting new patients
Physicians Clinic Inc Physician Assistant CurrentSince Jan 4, 2021 Accepting new patients
LMMC LLC Past Accepting new patients
LMMC Sioux Falls, LLC Past Accepting new patients
LMMC Council Bluffs LLLP PastSince Nov 24, 2024 Accepting new patients
LMMC Lincoln, LLC Past Accepting new patients

Locations

808 E Pierce St
Council Bluffs, IA 51503
Phone (712) 396-4340

415 E 23rd St
Ste A
Fremont, NE 68025
Phone (402) 721-8960

450 E 23rd St
Fremont, NE 68025
Phone (402) 721-1610

207 S Engdahl Ave
Oakland, NE 68045
Phone (402) 685-5683

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

825 S 169th St
Fl 3
Omaha, NE 68118
Phone (402) 354-5451

Interoperability endpoints

  • Direct secure messaging: thomas.homan@direct.nmhs.org

Organizations & group practices 7

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 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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1457447013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 WATSON ST",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252093",
            "telephone_number": "402-721-0773",
            "fax_number": "402-727-6047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 POWER DR STE 5",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515017701",
            "telephone_number": "712-309-3023"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 E 22nd St",
            "address_purpose": "LOCATION",
            "city": "Fremont",
            "state": "NE",
            "postal_code": "680252093",
            "country_code": "US",
            "telephone_number": "402-727-5500",
            "fax_number": "402-727-6047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOMAN",
        "first_name": "THOMAS",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "756",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "107710",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

Verify at the official NPI Registry.