Sara M Despain, MD
Individual provider Active NPI Family Medicine Physician · Offutt Afb, NE
NPI 1669812376 · NPPES record last updated Aug 15, 2024
Key facts
- NPI
- 1669812376
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- V1761 (TX)
- Practice address
- 2501 Capehart Rd
Offutt Afb, NE 68113-1043 - Phone
- (812) 219-4675
- NPI assigned
- Jun 26, 2013
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 6
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Gonzales Emergency Partners PLLC
Practice addresses (Care Compare)
1110 N Sarah Dewitt Dr
Gonzales, TX 78629-3311
Hospital & facility affiliations
- Memorial Hospital
- Christus Santa Rosa Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NE, TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170315001755 | NE | Practitioner - Family Practice |
2961635123 | Reassigns benefits to 2 organizations |
| I20240829000999 | TX | Practitioner - Family Practice | 2961635123 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| V1761 | TX | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gonzales Emergency Partners, PLLC | Current |
Accepting new patients | |
| Christus Trinity Clinic Texas | Family Medicine | Current |
Accepting new patients |
| Unmc Physicians | Current |
Accepting new patients | |
| Avera St Anthonys Hospital | Current | Accepting new patients | |
| Christus Trinity Clinic Texas | Current |
Accepting new patients | |
| Christus Santa Rosa Health Care Corporation | Past | Accepting new patients |
Locations
2620 W Faidley Ave
Grand Island, NE 68803
Phone (308) 382-6856
Emile 42nd St
Omaha, NE 68198
Phone (402) 552-6731
1110 N Sarah Dewitt Dr
Gonzales, TX 78629
Phone (830) 672-3845
630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888
Interoperability endpoints
- sdespain423056@christushealth.direct-ci.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | V1761 | TX | Yes |
| Family Medicine Physician | 207Q00000X | 7058 | NE |
Addresses
Primary practice location
2501 Capehart Rd
Offutt Afb, NE 68113-1043
Mailing address
2501 Capehart Rd
Offutt Afb, NE 68113-1043
Other practice location 1
11130 Christus Hls Fl Plaza33
San Antonio, TX 78251-3585
Phone (210) 703-9001
Other providers in Offutt Afb, NE
- Mariah Davis
- William Jacob Davis
- Robert Dougals Delair
- Brandon M Delpi
- James William Dent
- Shane Dennis Dieckman
- Andrew Dinsmoor
- Britanie Dollard
- James Dreher
- Brian Edick
All providers in Offutt Afb, NE · Family Medicine Physician in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.