NPIMap

Individual provider Active NPI

Russell J Ebke, M.D.

  • Family Medicine Physician
  • Crete, NE
National Provider Identifier
1548210438
Registry record updated Sep 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
17808 Issued in NE
Practice address
2910 Betten Dr
Crete, NE 68333-3084
Phone
(402) 826-2102
Fax
(402) 826-7950
NPI assigned
May 11, 2006
Last updated
Sep 8, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 17808 NE Primary

Addresses

Primary practice location

2910 Betten Dr
Crete, NE 68333-3084

Mailing address

PO Box 220
Crete, NE 68333-0220
Phone (402) 826-2102

Other identifiers 5

IdentifierTypeStateIssuer
0100476OtherNEUNITED HEALTHCARE
080178127OtherNERAILROAD MEDICARE
2703OtherNEMIDLANDS CHOICE
35706OtherNEBCBS OF NEBRASKA
0100475OtherNEUNITED HEALTHCARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101007001372 NE Practitioner - Family Practice 0648182576 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Nebraska College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crete Area Medical CenterGroup PAC ID 4385556216, shared by 6 NPIs, 20 clinicians

Practice addresses (Care Compare)

2910 Betten Dr
Crete, NE 68333-3084
Phone (402) 826-2102

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Crete Area Medical Center Current Accepting new patients
Crete Area Medical Center Family Medicine CurrentSince Jan 1, 2002 Accepting new patients
Crete Area Medical Center CurrentSince Jan 1, 2002 Accepting new patients
Summit Medical Center Past Accepting new patients
Wilber Care Center Inc Past Accepting new patients
Tabitha Inc Past Accepting new patients
Crete Area Medical Center Past Accepting new patients
Endocrine Consultants of Nebraska Past Accepting new patients
Crete Area Medical Center Past Accepting new patients

Locations

2910 Betten Dr
Crete, NE 68333
Phone (402) 826-1191

Interoperability endpoints

  • Direct secure messaging: rebke13514@hisp.bryanhealth.org

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Crete Area Medical CenterCrete, NE, CCN 28Z354 Hospital Corporate Director
W-2 Managing Employee
Operational/Managerial Control		 Jan 1, 2025
Jan 1, 2025
Jan 1, 2025
Crete Area Medical CenterCrete, NE, CCN 283468 Rural health clinic W-2 Managing Employee
Operational/Managerial Control		 Jun 1, 2015
Jun 1, 2015
Wilber Medical ClinicWilber, NE, CCN 283469 Rural health clinic Corporate Director
W-2 Managing Employee
Operational/Managerial Control		 Jan 1, 2025
Jun 1, 2015
Jun 1, 2015

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 9

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 11

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283904000000",
    "number": "1548210438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 220",
            "city": "CRETE",
            "state": "NE",
            "postal_code": "683330220",
            "telephone_number": "402-826-2102",
            "fax_number": "402-826-7950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 BETTEN DR",
            "city": "CRETE",
            "state": "NE",
            "postal_code": "683333084",
            "telephone_number": "402-826-2102",
            "fax_number": "402-826-7950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBKE",
        "first_name": "RUSSELL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2010-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "17808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0100476",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080178127",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "2703",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NEBRASKA",
            "identifier": "35706",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0100475",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crete, NE

Sources for this page

Verify at the official NPI Registry.