NPIMap

Individual provider Active NPI

Jenna L Prange, PA-C

  • Physician Assistant
  • Omaha, NE
National Provider Identifier
1467695643
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1439 Issued in NE
Practice address
8720 Frederick St Ste 100
Omaha, NE 68124-3071
Phone
(402) 397-0700
Fax
(402) 397-1807
NPI assigned
Apr 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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 1439 NE Primary

Addresses

Primary practice location

8720 Frederick St Ste 100
Omaha, NE 68124-3071

Mailing address

8720 Frederick St Ste 100
Omaha, NE 68124-3071
Phone (402) 397-0700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160316002054 NE Practitioner - Physician Assistant 2466758479 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arbor Heights Family Medicine, P.C.Group PAC ID 0749376515, 3 clinicians

Practice addresses (Care Compare)

8720 Frederick St
Omaha, NE 68124-3071
Phone (402) 397-0700

8720 Frederick St
Suite 100
Omaha, NE 68124-3076

Hospital & facility affiliations

  • CHI Health Bergan Mercy Hospital, Omaha, NE, CCN 280060
  • The Nebraska Methodist Hospital Hospital, Omaha, NE, CCN 280040
  • CHI Health Midlands Hospital, Papillion, NE, CCN 280105
  • CHI Health Lakeside Hospital, Omaha, NE, CCN 280130
  • CHI Health Immanuel Hospital, Omaha, NE, CCN 280081

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1439NEMDClinical Social Worker

Interoperability endpoints

  • Direct secure messaging: jlee@ahfm.gwaydirect.com

Organizations & group practices 1

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 6

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": "1239926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1467695643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8720 FREDERICK ST STE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681243071",
            "telephone_number": "402-397-0700",
            "fax_number": "402-397-1807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8720 FREDERICK ST STE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681243071",
            "telephone_number": "402-397-0700",
            "fax_number": "402-397-1807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRANGE",
        "first_name": "JENNA",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-17",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.