Individual provider Active NPI

Mackenzie Simone Laurila, D.O.

  • Anesthesiology Physician
  • Omaha, NE
National Provider Identifier
1730530916
Registry record updated Jun 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
7836 Issued in NE
Practice address
984150 Nebraska Medical Ctr
Omaha, NE 68198-4150
Phone
(402) 559-7405
NPI assigned
Jun 28, 2016
Last updated
Jun 28, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 7836 NE Primary

Addresses

Primary practice location

984150 Nebraska Medical Ctr
Omaha, NE 68198-4150

Mailing address

984150 Nebraska Medical Ctr
Omaha, NE 68198-4150
Phone (402) 559-7405

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
I20240502001758 NE Practitioner - Anesthesiology 3870888167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Father Flanagans Boys HomeGroup PAC ID 9638165400, 93 clinicians

Practice addresses (Care Compare)

14000 Boys Town Hospital Rd
Boys Town, NE 68010-7513
Phone (531) 355-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2446NEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Father Flanagan's Boys' Home Anesthesiology CurrentSince Mar 23, 2024 Accepting new patients

Locations

14000 Boys Town Hospital Rd
Boys Town, NE 68010
Phone (402) 778-6000

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

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.

Hospital & facility affiliations 1

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": "1467072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467072000000",
    "number": "1730530916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "984150 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681984150",
            "telephone_number": "402-559-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "984150 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681984150",
            "telephone_number": "402-559-7405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAURILA",
        "first_name": "MACKENZIE",
        "middle_name": "SIMONE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-28",
        "last_updated": "2016-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NE",
            "license": "7836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.