Individual provider Active NPI

Elisa Kay Wiest Cortez, DDS

  • Dentist
  • Omaha, NE
National Provider Identifier
1588998454
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6685 Issued in NE
Practice address
4920 South 30TH Street
Suite 103
Omaha, NE 68107-1656
Phone
(402) 734-4110
Fax
(402) 991-5642
NPI assigned
Sep 25, 2009
Last updated
Aug 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6685 NE Primary

Addresses

Primary practice location

4920 South 30TH Street
Suite 103
Omaha, NE 68107-1656

Mailing address

4920 S 30TH St Ste 103
Omaha, NE 68107-1656
Phone (402) 734-4110

Other names 1

  • Elisa K Wiest Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260518000636 IA Practitioner - Dentist 0648573402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Other, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

902 S 6TH St
Council Bluffs, IA 51501-6441

9425 Delegates Row
Indianapolis, IN 46240-3805

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6685NEMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
All Care Health Center CurrentSince May 12, 2026 Accepting new patients

Locations

902 S 6th St
Rm A
Council Bluffs, IA 51501

Interoperability endpoints

  • FHIR API: https://webprd.ochin.org/prd-fhir/allcarehealthcenter/api/FHIR/R4

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1253836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1588998454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4920 S 30TH ST STE 103",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681071656",
            "telephone_number": "402-734-4110",
            "fax_number": "402-991-5642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4920 SOUTH 30TH STREET",
            "address_2": "SUITE 103",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681071656",
            "telephone_number": "402-734-4110",
            "fax_number": "402-991-5642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEST CORTEZ",
        "first_name": "ELISA",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-25",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "6685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELISA",
            "last_name": "WIEST",
            "middle_name": "K",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.