Active NPI
Andrew Walid Mezher, MD
- General Practice Physician
- Omaha, NE
National Provider Identifier
1578192365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 64572
- Practice address
- 981045 Nebraska Medical Ctr
Omaha, NE 68198-4496 - Phone
- (402) 559-1018
- NPI assigned
- Apr 3, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 64572 | AZ | Primary |
Addresses
Primary practice location
981045 Nebraska Medical Ctr
Omaha, NE 68198-4496
Mailing address
3019 Decatur Street
Omaha, NE 68111
Phone (818) 442-4992
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220921000212 | NE | Order and Referring Only - Diagnostic Radiology | 0648655084 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 64572 | AZ | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659571200000",
"number": "1578192365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3019 DECATUR STREET",
"city": "OMAHA",
"state": "NE",
"postal_code": "68111",
"telephone_number": "818-442-4992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "981045 NEBRASKA MEDICAL CTR",
"city": "OMAHA",
"state": "NE",
"postal_code": "681984496",
"telephone_number": "402-559-1018"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEZHER",
"first_name": "ANDREW",
"middle_name": "WALID",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-03",
"last_updated": "2022-08-04",
"certification_date": "2022-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "AZ",
"license": "64572",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.