Individual provider Active NPI

Jennifer Inbarasu, M.D.

  • Child & Adolescent Psychiatry Physician
  • Boys Town, NE
National Provider Identifier
1689053456
Registry record updated Jul 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
32523 Issued in NE
Practice address
14092 Boys Town Hospital Rd
Boys Town, NE 68010
Phone
(531) 355-1449
NPI assigned
May 26, 2015
Last updated
Jul 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 61402 MN
Child & Adolescent Psychiatry Physician 2084P0804X 32523 NE Primary

Addresses

Primary practice location

14092 Boys Town Hospital Rd
Boys Town, NE 68010

Mailing address

14092 Boys Town Hospital Road
Omaha, NE 68010
Phone (531) 355-1449

Other practice location 1

200 1st St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Other names 1

  • Jennifer Wittry Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200722003031 NE Practitioner - PsychiatryPractitioner - Neurology 0749591972 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Father Flanagan's Boys' Home Child & Adolescent Psychiatry CurrentSince Jul 31, 2020 Accepting new patients
Father Flanagan's Boys' Home Past Accepting new patients
ENT Services PC Past Accepting new patients
Father Flanagan's Boys Home Past Accepting new patients

Locations

14080 Boys Town Hospital Rd
Boys Town, NE 68010
Phone (402) 778-6900

14092 Boys Town Hospital Rd
Boys Town, NE 68010
Phone (531) 355-1449

6715 S 180th St
Omaha, NE 68135
Phone (531) 355-2300

Organizations & group practices 4

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": "1432598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595548800000",
    "number": "1689053456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14092 BOYS TOWN HOSPITAL ROAD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68010",
            "telephone_number": "531-355-1449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14092 BOYS TOWN HOSPITAL RD",
            "city": "BOYS TOWN",
            "state": "NE",
            "postal_code": "68010",
            "telephone_number": "531-355-1449"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559050001",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "INBARASU",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-26",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "61402",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NE",
            "license": "32523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "WITTRY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boys Town, NE

Sources for this page

Verify at the official NPI Registry.