Individual provider Active NPI

Brandon L Reicks, PA

  • Physician Assistant
  • Omaha, NE
National Provider Identifier
1477856987
Registry record updated Oct 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
982035 Nebraska Medical Ctr
Omaha, NE 68198-2035
Phone
(402) 559-9614
Fax
(402) 559-7779
NPI assigned
Dec 6, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2013

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 Primary

Addresses

Primary practice location

982035 Nebraska Medical Ctr
Omaha, NE 68198-2035

Mailing address

982035 Nebraska Medical Ctr
Omaha, NE 68198-2035
Phone (402) 559-9614

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
I20110125000760 NE Practitioner - Physician Assistant 4486833324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
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)

4242 Farnam St
Omaha, NE 68131-2813

987400 Nebraska Medical Ctr
Unmc Physicians Nebraska Medical Center
Omaha, NE 68198-7400
Phone (402) 559-4000

Emile 42ND St
Omaha, NE 68198-0001
Phone (402) 559-4015

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1561NEMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
New Century Physicians of Nebraska LLC CurrentSince Sep 21, 2013 Accepting new patients

Locations

16901 Lakeside Hills Ct
Omaha, NE 68130
Phone (402) 572-6500

11111 S 84th St
Papillion, NE 68046
Phone (402) 593-3000

Interoperability endpoints

  • Direct secure messaging: breicks22414@direct.nebraskamed.com

Organizations & group practices 2

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": "1291593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381363200000",
    "number": "1477856987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "982035 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681982035",
            "telephone_number": "402-559-9614",
            "fax_number": "402-559-7779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "982035 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681982035",
            "telephone_number": "402-559-9614",
            "fax_number": "402-559-7779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REICKS",
        "first_name": "BRANDON",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-06",
        "last_updated": "2013-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.