Individual provider Active NPI

Mark D Chouinard, MD

  • Cardiovascular Disease Physician
  • Omaha, NE
National Provider Identifier
1487615316
Registry record updated Jun 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
18631 Issued in NE
Practice address
1120 N 103Rd PLZ
Suite 100
Omaha, NE 68114-1114
Phone
(402) 391-5055
Fax
(402) 391-5053
NPI assigned
Mar 30, 2006
Last updated
Jun 12, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 18631 NE Primary

Addresses

Primary practice location

1120 N 103Rd PLZ
Suite 100
Omaha, NE 68114-1114

Mailing address

PO Box 3755
Omaha, NE 68103-0755
Phone (402) 354-2100

Other identifiers 5

IdentifierTypeStateIssuer
100264489-00MedicaidNE
1487615316OtherIAWELLMARK - RED OAK, IA LOCATION
100264483-00MedicaidNE
100264481-00MedicaidNE
1487615316MedicaidIA

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: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20031208000345 NE Practitioner - Cardiovascular Disease (Cardiology) 3274439799 Reassigns benefits to 2 organizations
I20040225000016 IA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 3274439799 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Medical College of Georgia School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Clinic IncGroup PAC ID 4880506062, 557 clinicians
Nebraska Methodist HospitalGroup PAC ID 6901707447, 132 clinicians

Practice addresses (Care Compare)

10060 Regency Cir
Omaha, NE 68114-3732
Phone (402) 354-1570

1120 N 103Rd Plaza
200 Cardiothoracic Surgery
Omaha, NE 68114-1119
Phone (402) 354-0400

1120 N 103Rd PLZ
Omaha, NE 68114-1119

16120 W Dodge Rd
Omaha, NE 68118-2049
Phone (402) 354-0550

2301 Eastern Ave
Red Oak, IA 51566-1300

2540 N Healthy Way
Fremont, NE 68025-2315
Phone (402) 721-7077

450 E 23Rd St
Fremont, NE 68025-2303
Phone (402) 721-1610

707 N 190TH Plaza
Elkhorn, NE 68022-3974
Phone (402) 815-4000

717 N 190TH Plaza
Suite 2400
Elkhorn, NE 68022-3974
Phone (402) 815-1901

810 N 22ND St
Methodist Physicians Clinic Heart Consults
Blair, NE 68008-1128
Phone (402) 426-2182

812 N 22ND St
Memorial Community Hospital Out Patient Cli
Blair, NE 68008-1128
Phone (402) 426-1239

8303 Dodge St
Omaha, NE 68114-4108
Phone (402) 354-8163

8303 W Dodge St
Omaha, NE 68114-4108
Phone (402) 354-9400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nebraska Methodist Hospital Current Accepting new patients
Nebraska Methodist Hospital Cardiovascular Disease CurrentSince Feb 8, 2010 Accepting new patients
Physicians Clinic Inc CurrentSince Dec 31, 2014 Accepting new patients
Alegent Creighton Health Past Accepting new patients
Heart Consultants PC Past Accepting new patients

Locations

1 Edmundson Pl
Ste 310
Council Bluffs, IA 51503
Phone (712) 328-1801

810 N 22nd St
Blair, NE 68008
Phone (402) 426-1116

707 N 190th Plz
Elkhorn, NE 68022
Phone (402) 354-4000

426 E 22nd St
Ste 100
Fremont, NE 68025
Phone (402) 727-7796

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

1120 N 103rd Plz
Ste 100
Omaha, NE 68114
Phone (402) 391-5055

8303 Dodge St
Ste LL6
Omaha, NE 68114
Phone (402) 354-4104

8601 W Dodge Rd
Ste 216
Omaha, NE 68114
Phone (402) 354-4822

Interoperability endpoints

  • Direct secure messaging: mark.chouinard@direct.nmhs.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434067200000",
    "number": "1487615316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3755",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681030755",
            "telephone_number": "402-354-2100",
            "fax_number": "402-354-6171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 N 103RD PLZ",
            "address_2": "SUITE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681141114",
            "telephone_number": "402-391-5055",
            "fax_number": "402-391-5053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOUINARD",
        "first_name": "MARK",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-30",
        "last_updated": "2015-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NE",
            "license": "18631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100264489-00",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK - RED OAK, IA LOCATION",
            "identifier": "1487615316",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100264483-00",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100264481-00",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487615316",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.