Individual provider Active NPI

Ryan Kirk Sewell, MD

  • Otolaryngology Physician
  • Omaha, NE
National Provider Identifier
1740300482
Registry record updated Jan 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
25702 Issued in NE
Practice address
720 N 129TH St
Omaha, NE 68154-6109
Phone
(402) 397-0670
Fax
(402) 397-0713
NPI assigned
Mar 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 25702 NE Primary

Addresses

Primary practice location

720 N 129TH St
Omaha, NE 68154-6109

Mailing address

720 N 129TH St
Omaha, NE 68154-6109
Phone (402) 397-0670

Other identifiers 1

IdentifierTypeStateIssuer
47056003300MedicaidNE

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
I20100817001342 NE Practitioner - Otolaryngology 8628122462 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25702NEMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
ENT Specialists PC Otolaryngology CurrentSince Aug 1, 2010 Accepting new patients
Children'S Specialty Physician Billing Past Accepting new patients
Nebraska Pediatric Practice, Inc Past Accepting new patients

Locations

720 N 129th St
Omaha, NE 68154
Phone (402) 397-0670

Interoperability endpoints

  • Direct secure messaging: ryansewell@entspecial.allscriptsdirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453248000000",
    "number": "1740300482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 N 129TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681546109",
            "telephone_number": "402-397-0670",
            "fax_number": "402-397-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 N 129TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681546109",
            "telephone_number": "402-397-0670",
            "fax_number": "402-397-0713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEWELL",
        "first_name": "RYAN",
        "middle_name": "KIRK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2016-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NE",
            "license": "25702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47056003300",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.