NPIMap

Individual provider Active NPI

Kristina Ann Dada, PA-C

  • Medical Physician Assistant
  • Omaha, NE
National Provider Identifier
1487830097
Registry record updated Apr 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1369 Issued in NE
Practice address
7710 Mercy Rd Ste 3000
Omaha, NE 68124-2350
Phone
(402) 717-9600
Fax
(402) 717-6014
NPI assigned
Jan 14, 2008
Last updated
Apr 11, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1369 NE Primary

Addresses

Primary practice location

7710 Mercy Rd Ste 3000
Omaha, NE 68124-2350

Mailing address

7261 Mercy Rd
Omaha, NE 68124-2311
Phone (402) 398-6248

Other practice location 1

643 N 98th St # 148
Omaha, NE 68114-2370
Phone (402) 312-8733

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, NE2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080509000294 IA Practitioner - Physician Assistant 5991884330 Reassigns benefits to 1 organization
I20080509000300 NE Practitioner - Physician Assistant 5991884330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians

Practice addresses (Care Compare)

16909 Lakeside Hills CT
Omaha, NE 68130-4661

1870 No 75 St
Omaha, NE 68124-1700
Phone (402) 898-2702

800 Mercy Dr
Council Bluffs, IA 51503-3128

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic CurrentSince Apr 1, 2016 Accepting new patients
Alegent Creighton Clinic Medical CurrentSince Jan 1, 2018 Accepting new patients
Pulmonary Medicine Specialists PC Medical Past Accepting new patients
Stephen J. Kruszka D.O., P.C. Past Accepting new patients

Locations

603 Rosary Dr
Corning, IA 50841
Phone (641) 322-3121

800 Mercy Dr
Ste 220
Council Bluffs, IA 51503
Phone (712) 388-2660

407 S 19th St
Blair, NE 68008
Phone (402) 426-2210

16909 Lakeside Hills Ct
Ste 401
Omaha, NE 68130
Phone (402) 827-4920

1870 S 75th St
Omaha, NE 68124
Phone (402) 361-5700

2725 S 144th St
Ste 212
Omaha, NE 68144
Phone (402) 354-4000

7261 Mercy Rd
Omaha, NE 68124
Phone (402) 398-6248

7710 Mercy Rd
Ste 3000
Omaha, NE 68124
Phone (402) 717-9600

7710 Mercy Rd
Ste 428
Omaha, NE 68124
Phone (402) 392-1404

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 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": "1200268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523404800000",
    "number": "1487830097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7261 MERCY RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242311",
            "telephone_number": "402-398-6248",
            "fax_number": "402-829-8513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7710 MERCY RD STE 3000",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242350",
            "telephone_number": "402-717-9600",
            "fax_number": "402-717-6014"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "643 N 98th St # 148",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681142370",
            "country_code": "US",
            "telephone_number": "402-312-8733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DADA",
        "first_name": "KRISTINA",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-14",
        "last_updated": "2018-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "1369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.