Individual provider Active NPI

Andy Robert Welstead, D.O.

  • Internal Medicine Physician
  • Omaha, NE
National Provider Identifier
1508126756
Registry record updated Aug 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
1470 Issued in NE
Practice address
10060 Regency Cir
Omaha, NE 68114-3732
Phone
(402) 354-1580
Fax
(402) 354-1409
NPI assigned
May 22, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 1470 NE Primary

Addresses

Primary practice location

10060 Regency Cir
Omaha, NE 68114-3732

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
1508126756MedicaidIA
47068731742MedicaidNE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190723000095 NE Practitioner - Internal Medicine 9830323963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
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

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Omaha, NE, CCN 287038
  • Home Nursing With Heart Home health agency, Omaha, NE, CCN 287126
  • The Nebraska Methodist Hospital Hospital, Omaha, NE, CCN 280040
  • CHI Health Bergan Mercy Hospital, Omaha, NE, CCN 280060
  • CHI Health Lakeside Hospital, Omaha, NE, CCN 280130

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1470NEMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Clinic Inc Internal Medicine CurrentSince Aug 31, 2019 Accepting new patients

Locations

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

825 S 169th St
Omaha, NE 68118
Phone (402) 354-3370

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": "1337644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1508126756",
    "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": "402-354-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10060 REGENCY CIR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681143732",
            "telephone_number": "402-354-1580",
            "fax_number": "402-354-1409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELSTEAD",
        "first_name": "ANDY",
        "middle_name": "ROBERT",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-22",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "1470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508126756",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47068731742",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.