Individual provider Active NPI

Sara M Despain, MD

  • Family Medicine Physician
  • Offutt AFB, NE
National Provider Identifier
1669812376
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
V1761 Issued in TX
Practice address
2501 Capehart Rd
Offutt AFB, NE 68113-1043
Phone
(812) 219-4675
NPI assigned
Jun 26, 2013
Last updated
Aug 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X V1761 TX Primary
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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170315001755 NE Practitioner - Family PracticePractitioner - Emergency Medicine 2961635123 Reassigns benefits to 2 organizations
I20240829000999 TX Practitioner - Family Practice 2961635123 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gonzales Emergency Partners PLLCGroup PAC ID 3971964032, 7 clinicians

Practice addresses (Care Compare)

1110 N Sarah Dewitt Dr
Gonzales, TX 78629-3311

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
7058NEMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas Family Medicine CurrentSince Oct 7, 2024 Accepting new patients
Gonzales Emergency Partners, PLLC CurrentSince Jan 12, 2025 Accepting new patients
Unmc Physicians CurrentSince Oct 24, 2017 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Oct 7, 2024 Accepting new patients
Avera St Anthonys Hospital 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

  • Direct secure messaging: sdespain423056@christushealth.direct-ci.net

Organizations & group practices 6

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": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1669812376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 CAPEHART RD",
            "city": "OFFUTT AFB",
            "state": "NE",
            "postal_code": "681131043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 CAPEHART RD",
            "city": "OFFUTT AFB",
            "state": "NE",
            "postal_code": "681131043",
            "telephone_number": "812-219-4675"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11130 Christus Hls Fl Plaza33",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782513585",
            "country_code": "US",
            "telephone_number": "210-703-9001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESPAIN",
        "first_name": "SARA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-26",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "V1761",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "7058",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Offutt AFB, NE

Sources for this page

Verify at the official NPI Registry.