Individual provider Active NPI

Andrew M Coughlin, M.D.

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Omaha, NE
National Provider Identifier
1578714440
Registry record updated Jan 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X
License
27214 Issued in NE
Practice address
8303 Dodge St
Suite 304
Omaha, NE 68114-4108
Phone
(402) 354-5048
Fax
(402) 354-2585
NPI assigned
Oct 8, 2008
Last updated
Jan 24, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 27214 NE
Otolaryngology Physician 207Y00000X BP10032053 TX
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X 27214 NE Primary

Addresses

Primary practice location

8303 Dodge St
Suite 304
Omaha, NE 68114-4108

Mailing address

PO Box 10190
Virginia Beach, VA 23450-0190
Phone (800) 477-5240

Other identifiers 3

IdentifierTypeStateIssuer
10026485711MedicaidNE
100250444-00MedicaidNE
1578714440MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140617001292 NE Practitioner - Plastic and Reconstructive SurgeryPractitioner - General PracticePractitioner - OtolaryngologyPractitioner - Surgical Oncology 8022232867 Reassigns benefits to 3 organizations
I20170908000087 IA Practitioner - Otolaryngology 8022232867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Nebraska College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nebraska Methodist HospitalGroup PAC ID 6901707447, 132 clinicians

Practice addresses (Care Compare)

1 Edmundson PL
Council Bluffs, IA 51503-4658
Phone (712) 396-4130

8303 Dodge St
Omaha, NE 68114-4108

8303 W Dodge St
Omaha, NE 68114-4108
Phone (402) 354-9400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision58
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27214NEMDOtolaryngology Physician
BP10032053TXMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unmc Physicians CurrentSince Jul 1, 2014 Accepting new patients
Nebraska Methodist Hospital Current Accepting new patients
Nebraska Methodist Hospital CurrentSince Jul 31, 2014 Accepting new patients
Physicians Clinic Inc Otolaryngology CurrentSince Jun 15, 2018 Accepting new patients
Boone County Hospital Past Accepting new patients

Locations

1 Edmundson Pl
Council Bluffs, IA 51503
Phone (712) 396-4000

1 Edmundson Pl
Ste 100
Council Bluffs, IA 51503
Phone (712) 396-4429

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

515 N 162nd Ave
Ste 302
Omaha, NE 68118
Phone (402) 354-0621

825 S 169th St
Omaha, NE 68118
Phone (402) 354-3370

8303 Dodge St
Ste 304
Omaha, NE 68114
Phone (402) 354-4104

8601 W Dodge Rd
Ste 216
Omaha, NE 68114
Phone (402) 354-4822

987400 Nebraska Medical Ctr
Omaha, NE 68198
Phone (402) 559-3405

Emile 42nd St
Omaha, NE 68198
Phone (402) 552-6731

Interoperability endpoints

  • Direct secure messaging: andrew.coughlin@direct.nmhs.org

Organizations & group practices 5

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 2

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": "1223424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516752000000",
    "number": "1578714440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10190",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234500190",
            "telephone_number": "800-477-5240",
            "fax_number": "757-463-6572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8303 DODGE ST",
            "address_2": "SUITE 304",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144108",
            "telephone_number": "402-354-5048",
            "fax_number": "402-354-2585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUGHLIN",
        "first_name": "ANDREW",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-08",
        "last_updated": "2018-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NE",
            "license": "27214",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "BP10032053",
            "primary": false
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "NE",
            "license": "27214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026485711",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100250444-00",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578714440",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.