Individual provider Active NPI

Zachariah Luke Wittenberg, DO

  • Pulmonary Disease Physician
  • Omaha, NE
National Provider Identifier
1538654785
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
2533 Issued in NE
Practice address
1120 N 103Rd PLZ
Omaha, NE 68114-1114
Phone
(402) 391-5055
NPI assigned
Jun 28, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 2533 NE Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 2533 NE

Addresses

Primary practice location

1120 N 103Rd PLZ
Omaha, NE 68114-1114

Mailing address

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

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
I20221014001647 NE Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 2062764467 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2018
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)

1120 N 103Rd PLZ
102 Methodist Physicians Clinic Pulmonary M
Omaha, NE 68114-1119
Phone (402) 354-0220

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8285NEMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
CHI Health Clinic Specialty, LLC Pulmonary Disease CurrentSince Nov 1, 2022 Accepting new patients
Physicians Clinic Inc Internal Medicine CurrentSince Jul 13, 2024 Accepting new patients

Locations

2620 W Faidley Ave
Grand Island, NE 68803
Phone (308) 382-6856

8207 Northwoods Dr
Ste 100
Lincoln, NE 68505
Phone (402) 484-3440

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

1120 N 103rd Plz
Ste 102
Omaha, NE 68114
Phone (402) 354-0120

825 S 169th St
#3
Omaha, NE 68118

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

Organizations & group practices 2

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": "1530144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1538654785",
    "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": "1120 N 103RD PLZ",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681141114",
            "telephone_number": "402-391-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTENBERG",
        "first_name": "ZACHARIAH",
        "middle_name": "LUKE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-28",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NE",
            "license": "2533",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NE",
            "license": "2533",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.