Individual provider Active NPI

Rebecca D Witt, PA-C

  • Physician Assistant
  • Omaha, NE
National Provider Identifier
1649221110
Registry record updated Sep 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1055 Issued in NE
Practice address
17030 Lakeside Hills PLZ
#102
Omaha, NE 68130-2396
Phone
(402) 758-5800
Fax
(402) 758-5809
NPI assigned
May 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1055 NE Primary

Addresses

Primary practice location

17030 Lakeside Hills PLZ
#102
Omaha, NE 68130-2396

Mailing address

3800 Old Cheney Rd
#101-331
Lincoln, NE 68516-5901
Phone (402) 758-5800

Other identifiers 1

IdentifierTypeStateIssuer
39024OtherNEBLUE CROSS BLUE SHIELD

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
I20061204000347 NE Practitioner - Physician Assistant 7618976556 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Curana Health of Iowa PLLCGroup PAC ID 9133536113, 152 clinicians
Unmc PhysiciansGroup PAC ID 6002728391, 1,490 clinicians

Practice addresses (Care Compare)

11308 Blondo St
Omaha, NE 68164-3822
Phone (337) 991-9276

1203 E Hynes Ave
Oneill, NE 68763-1451
Phone (337) 991-9276

4014 Leavenworth St
Omaha, NE 68105-1053
Phone (402) 552-7928

4451 Old Cheney Rd
Lincoln, NE 68516-2821
Phone (337) 991-9276

7337 Hickory St
Omaha, NE 68124-1677
Phone (337) 991-9276

987400 Nebraska Medical Ctr
Unmc Physicians Nebraska Medical Center
Omaha, NE 68198-7400
Phone (402) 559-4000

Emile 42ND St
Omaha, NE 68198-0001
Phone (402) 559-4015

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1055NEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic Physician Assistant Past Accepting new patients
Alegent Creighton Clinic Past Accepting new patients

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190851200000",
    "number": "1649221110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 OLD CHENEY RD",
            "address_2": "#101-331",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685165901",
            "telephone_number": "402-758-5800",
            "fax_number": "402-758-5809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17030 LAKESIDE HILLS PLZ",
            "address_2": "#102",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681302396",
            "telephone_number": "402-758-5800",
            "fax_number": "402-758-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITT",
        "first_name": "REBECCA",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2007-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "39024",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.