George William Dittrick, M.D.

Primary specialty

Surgical Oncology PhysicianTaxonomy code 2086X0206X

License

25264 Issued in NE

Practice address

8111 Dodge St
Ste. 263
Omaha, NE 68114-4129

Phone

(402) 354-8163

Fax

(402) 354-2416

NPI assigned

Dec 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Surgical OncologyAlso: General Surgery

Education

University of Nebraska College of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physicians Clinic IncGroup PAC ID 4880506062, 557 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Nebraska Methodist Hospital Hospital, Omaha, NE, CCN 280040
• Methodist Jennie Edmundson Hospital, Council Bluffs, IA, CCN 160047
• Community Hospital Association Hospital, Fairfax, MO, CCN 261303

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: george.dittrick@direct.nmhs.org

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.

• Physicians Clinic Inc

  • Family Medicine Physician
  • Omaha, NE
  • NPI 1821049156
  Medicare reassignment Care Compare group NPD
• Nebraska Methodist Hospital

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1427147883
  NPD
• Physicians Clinic, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Omaha, NE
  • NPI 1770673923
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Nebraska Methodist Hospital

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1427147883
  Care Compare affiliation
• Community Hospital Association

  • Critical Access Hospital
  • Fairfax, MO
  • NPI 1942279500
  Care Compare affiliation
• Jennie Edmundson Memorial Hospital

  • General Acute Care Hospital
  • Council Bluffs, IA
  • NPI 1457448755
  Care Compare affiliation

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462406400000",
    "number": "1669530630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3755",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681030755",
            "telephone_number": "402-354-2100",
            "fax_number": "402-354-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8111 DODGE ST",
            "address_2": "STE. 263",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144129",
            "telephone_number": "402-354-8163",
            "fax_number": "402-354-2416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITTRICK",
        "first_name": "GEORGE",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2016-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "FL",
            "license": "ME103180",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME103180",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "NE",
            "license": "25264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669530630",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47068731707",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025868900",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• District 127 Hair Atelier
• Taylor Ditoro
• Lee Dittman, PLMHP
• Karen I Dittmer-McMahon, PHD
• Kerri Dittrich
• Cheila Marie Ditzler, APRN
• Diversified Healthcare Inc.
• Diversified Healthcare, Inc.
• Diversified Mobile PT LLC
• Suzanne Divett, CHORE PROVIDER

• Surgical Oncology Physician in Omaha, NE
• Providers in Omaha, NE by specialty
• Surgical Oncology Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.