Active NPI
Brittney Bostic, PA
- Physician Assistant
- Boys Town, NE
National Provider Identifier
1659634400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 14000 Boys Town Hospital Rd
Boys Town, NE 68010-7513 - Phone
- (531) 355-6540
- NPI assigned
- Jun 18, 2012
- Last updated
- Sep 23, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2041 | NE | |
| Physician Assistant | 363A00000X | 127743 | IA | |
| Physician Assistant | 363A00000X | NU | Primary |
Addresses
Primary practice location
14000 Boys Town Hospital Rd
Boys Town, NE 68010-7513
Mailing address
3315 N 128TH Cir
Omaha, NE 68164-4235
Phone (716) 807-5722
Other names 1
- Brittney Grimaldi
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE, IA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015657 | NY | MD | Mental Health Counselor |
| 127743 | IA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Century Physicians of Nebraska LLC | Current | Accepting new patients | |
| Father Flanagan's Boys Home | Past | Accepting new patients | |
| Braeburn Emergency Physicians LLC | Past | Accepting new patients |
Locations
16901 Lakeside Hills Ct
Omaha, NE 68130
Phone (402) 572-6500
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.
-
dba Boys Town Professional Services
- Pediatrics Physician
- Omaha, NE
- NPI 1295821825
-
- Emergency Medicine Physician
- Papillion, NE
- NPI 1063411833
-
dba Boys Town Center for Behavioral Health
- Psychologist
- Boys Town, NE
- NPI 1265405419
-
- Emergency Medicine Physician
- Salem, VA
- NPI 1467888263
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727049600000",
"number": "1659634400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3315 N 128TH CIR",
"city": "OMAHA",
"state": "NE",
"postal_code": "681644235",
"telephone_number": "716-807-5722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14000 BOYS TOWN HOSPITAL RD",
"city": "BOYS TOWN",
"state": "NE",
"postal_code": "680107513",
"telephone_number": "531-355-6540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOSTIC",
"first_name": "BRITTNEY",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-18",
"last_updated": "2024-09-23",
"certification_date": "2024-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NE",
"license": "2041",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IA",
"license": "127743",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "BRITTNEY",
"last_name": "GRIMALDI",
"credential": "PA",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Boys Town, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.