Individual provider Active NPI

Cristina Blasa Thomas, NURSE PRACTITIONER

  • Nurse Practitioner
  • Omaha, NE
National Provider Identifier
1598449035
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
114722 Issued in NE
Practice address
11819 Miracle Hills Drive #203
Omaha, NE 68154
Phone
(402) 201-2373
NPI assigned
Jun 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 114722 NE Primary

Addresses

Primary practice location

11819 Miracle Hills Drive #203
Omaha, NE 68154

Mailing address

11819 Miracle Hills Drive #203
Omaha, NE 68154
Phone (402) 201-2373

Other names 1

  • Cristina Blasa Guerra Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231120003025 NE Practitioner - Nurse Practitioner 0345698940 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1686700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1598449035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11819 MIRACLE HILLS DRIVE #203",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68154",
            "telephone_number": "402-201-2373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11819 MIRACLE HILLS DRIVE #203",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68154",
            "telephone_number": "402-201-2373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "CRISTINA",
        "middle_name": "BLASA",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-14",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NE",
            "license": "114722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRISTINA",
            "last_name": "GUERRA",
            "middle_name": "BLASA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.