Individual provider Active NPI

Brittney Bostic, PA

  • Physician Assistant
  • Boys Town, NE
National Provider Identifier
1659634400
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
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, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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 Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170201000810 NE Practitioner - Physician Assistant 3779735584 Reassigns benefits to 2 organizations
I20240913003038 IA Practitioner - Physician Assistant 3779735584 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
015657NYMDMental Health Counselor
127743IAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New Century Physicians of Nebraska LLC CurrentSince Feb 25, 2020 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.

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

Verify at the official NPI Registry.