Individual provider Active NPI

Mindy Oetter, OTRL

  • Occupational Therapist
  • Omaha, NE
National Provider Identifier
1740369503
Registry record updated Jul 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
716 Issued in NE
Practice address
444 S 44TH St
Omaha, NE 68131-3727
Phone
(402) 559-6415
NPI assigned
Nov 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 716 NE Primary

Addresses

Primary practice location

444 S 44TH St
Omaha, NE 68131-3727

Mailing address

985450 Nebraska Med Ctr
Omaha, NE 68198-5450
Phone (402) 559-8943

Other identifiers 1

IdentifierTypeStateIssuer
10025291000MedicaidNE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100420000467 NE Practitioner - Occupational Therapist in Private Practice 6002943297 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Nebraska Board of RegentsGroup PAC ID 3971564279, 44 clinicians

Practice addresses (Care Compare)

6902 Pine St
Omaha, NE 68106-2855
Phone (402) 559-6418

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
716NEMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
University of Nebraska Board of Regents CurrentSince Nov 1, 2009 Accepting new patients
University of Nebraska Board of Regents CurrentSince Nov 1, 2009 Accepting new patients
University of Nebraska Board of Regents Past Accepting new patients

Locations

6902 Pine St
Omaha, NE 68106
Phone (402) 559-6418

985450 Nebraska Medical Ctr
Omaha, NE 68198
Phone (402) 559-6408

444 S 44th St
Omaha, NE 68131
Phone (402) 559-3563

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": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341964800000",
    "number": "1740369503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "985450 NEBRASKA MED CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681985450",
            "telephone_number": "402-559-8943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 S 44TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681313727",
            "telephone_number": "402-559-6415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OETTER",
        "first_name": "MINDY",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2012-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NE",
            "license": "716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025291000",
            "state": "NE"
        }
    ],
    "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 11, 2012; 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.