Individual provider Active NPI

Nicole Ann Pearsall, M.D.

  • Obstetrics & Gynecology Physician
  • Omaha, NE
National Provider Identifier
1518170737
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
25716 Issued in NE
Practice address
16910 Marcy St Ste 200
Omaha, NE 68118-2704
Phone
(402) 697-7200
Fax
(402) 697-7282
NPI assigned
May 7, 2007
Last updated
Oct 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 25716 NE Primary

Addresses

Primary practice location

16910 Marcy St Ste 200
Omaha, NE 68118-2704

Mailing address

16910 Marcy St Ste 200
Omaha, NE 68118-2704
Phone (402) 697-7200

Other identifiers 1

IdentifierTypeStateIssuer
25716OtherNEMEDICAL LICENSE

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
I20101005000153 NE Practitioner - Obstetrics/Gynecology 1658563010 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Creighton University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associates in Womens Health LLCGroup PAC ID 6002871043, 9 clinicians

Practice addresses (Care Compare)

16910 Marcy St
Suite 200
Omaha, NE 68118-2714
Phone (402) 697-7200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25716NEMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Womens Health, L.L.C. Obstetrics & Gynecology CurrentSince Aug 1, 2010 Accepting new patients
Kbas LLC PastSince Aug 1, 2010 Accepting new patients
Alegent Creighton Health Past Accepting new patients

Locations

16910 Marcy St
Ste 200
Omaha, NE 68118
Phone (402) 697-7200

17001 Lakeside Hills Plz
Ste 100
Omaha, NE 68130
Phone (402) 614-6336

Interoperability endpoints

  • Direct secure messaging: nicole.pearsall@kbnsmed.directbygreenway.com
  • Direct secure messaging: npearsall@awh.gwaydirect.com

Organizations & group practices 3

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 1

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": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1518170737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16910 MARCY ST STE 200",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681182704",
            "telephone_number": "402-697-7200",
            "fax_number": "402-697-7282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16910 MARCY ST STE 200",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681182704",
            "telephone_number": "402-697-7200",
            "fax_number": "402-697-7282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSALL",
        "first_name": "NICOLE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NE",
            "license": "25716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "25716",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.