Individual provider Active NPI

Bethany Jean Levy, PA

  • Medical Physician Assistant
  • Omaha, NE
National Provider Identifier
1659416774
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1299 Issued in NE
Practice address
4920 S 30TH St
Suite 103
Omaha, NE 68107-1590
Phone
(402) 734-4110
Fax
(402) 991-5642
NPI assigned
Feb 20, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1299 NE Primary

Addresses

Primary practice location

4920 S 30TH St
Suite 103
Omaha, NE 68107-1590

Mailing address

4920 S 30TH St
Suite 103
Omaha, NE 68107-1590
Phone (402) 734-4110

Other names 1

  • Bethany Jean Larson 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
I20080717000651 NE Practitioner - Physician Assistant 6507939998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1299NEMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Oneworld Community Health Centers, Inc. CurrentSince Mar 22, 2010 Accepting new patients
Oneworld Community Health Centers, Inc. CurrentSince Mar 22, 2010 Accepting new patients
Oneworld Community Health Centers, Inc. Past Accepting new patients
Oneworld Community Health Centers, Inc. Past Accepting new patients

Locations

2207 Georgia Ave
Bellevue, NE 68005
Phone (402) 502-8855

2723 Q St
Omaha, NE 68107
Phone (402) 320-5188

4229 N 90th St
Omaha, NE 68134
Phone (402) 401-6000

4920 S 30th St
Ste 103
Omaha, NE 68107

5616 L St
Omaha, NE 68117
Phone (402) 881-2743

122 S 6th St
Plattsmouth, NE 68048
Phone (402) 296-2345

Interoperability endpoints

  • Direct secure messaging: bethany.levy.p1@direct.oneworldomaha.nextgenshare.com

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, 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": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659416774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4920 S 30TH ST",
            "address_2": "SUITE 103",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681071590",
            "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 S 30TH ST",
            "address_2": "SUITE 103",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681071590",
            "telephone_number": "402-734-4110",
            "fax_number": "402-991-5642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVY",
        "first_name": "BETHANY",
        "middle_name": "JEAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "1299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETHANY",
            "last_name": "LARSON",
            "middle_name": "JEAN",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.