Individual provider Active NPI

Jessica Elizabeth Boro Grosse, MPAS, PA-C

  • Physician Assistant
  • Omaha, NE
National Provider Identifier
1508931510
Registry record updated May 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1336 Issued in NE
Practice address
7100 W Center Rd
Omaha, NE 68106-2714
Phone
(402) 506-9000
Fax
(402) 506-9093
NPI assigned
Nov 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2020

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 1336 NE Primary

Addresses

Primary practice location

7100 W Center Rd
Omaha, NE 68106-2714

Mailing address

7100 W Center Rd
Omaha, NE 68106-2714
Phone (402) 506-9000

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
I20080721000056 NE Practitioner - Physician Assistant 2567535867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Think Aksarben LLCGroup PAC ID 9638394505, 77 clinicians

Practice addresses (Care Compare)

7100 W Ctr Rd
Omaha, NE 68106-2714
Phone (402) 506-9000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1336NEMDClinical Social Worker

Interoperability endpoints

  • Direct secure messaging: jessicagrosse@thinkaks.allscriptsdirect.net

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 3

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": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588723200000",
    "number": "1508931510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7100 W CENTER RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681062714",
            "telephone_number": "402-506-9000",
            "fax_number": "402-506-9093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7100 W CENTER RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681062714",
            "telephone_number": "402-506-9000",
            "fax_number": "402-506-9093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSE",
        "first_name": "JESSICA",
        "middle_name": "ELIZABETH BORO",
        "name_prefix": "Mrs.",
        "credential": "MPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-22",
        "last_updated": "2020-05-06",
        "certification_date": "2020-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.