Individual provider Active NPI

Kristin M Fernau, AU. D

  • Audiologist
  • Omaha, NE
National Provider Identifier
1700309788
Registry record updated Jul 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
355 Issued in NE
Practice address
17410 Burke St Ste 200
Omaha, NE 68118-2250
Phone
(402) 758-5330
Fax
(402) 758-5339
NPI assigned
Jul 20, 2017
Last updated
Jul 20, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 355 NE Primary

Addresses

Primary practice location

17410 Burke St Ste 200
Omaha, NE 68118-2250

Mailing address

19603 Laci St
Omaha, NE 68135-4264

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171005003273 NE Practitioner - Qualified Audiologist 0648545368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Omaha Ear Nose and Throat Clinic PCGroup PAC ID 3577636471, 3 clinicians

Practice addresses (Care Compare)

17410 Burke St
Suite 200
Omaha, NE 68118-2250
Phone (402) 758-5330

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Omaha Ear Nose & Throat Clinic PC CurrentSince Jul 11, 2017 Accepting new patients

Locations

17410 Burke St
Ste 200
Omaha, NE 68118
Phone (402) 758-5330

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 1

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": "1500508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500508800000",
    "number": "1700309788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19603 LACI ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681354264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17410 BURKE ST STE 200",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681182250",
            "telephone_number": "402-758-5330",
            "fax_number": "402-758-5339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNAU",
        "first_name": "KRISTIN",
        "middle_name": "M",
        "credential": "AU. D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-20",
        "last_updated": "2017-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NE",
            "license": "355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.