NPIMap

Individual provider Active NPI

Batsirai Mutize, PA

  • Physician Assistant
  • Omaha, NE
National Provider Identifier
1750528733
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1509 Issued in NE
Practice address
2725 S 144TH St Ste 212
Omaha, NE 68144-5253
Phone
(402) 637-0800
Fax
(402) 637-0808
NPI assigned
Jan 14, 2009
Last updated
Mar 29, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1509 NE Primary
Surgical Physician Assistant 363AS0400X NU

Addresses

Primary practice location

2725 S 144TH St Ste 212
Omaha, NE 68144-5253

Mailing address

7261 Mercy Rd
Omaha, NE 68124-2311
Phone (402) 398-6248

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address onclinic@orthonebraska.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100702000487 NE Practitioner - Physician Assistant 8123184454 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians

Practice addresses (Care Compare)

11111 S 84TH St
Papillion, NE 68046-4122
Phone (402) 898-2520

16901 Lakeside Hills CT
Omaha, NE 68130-2318
Phone (855) 524-4001

16909 Lakeside Hills CT
Omaha, NE 68130-4661

6901 N 72ND St
Omaha, NE 68122-1709

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0710SDMDPhysical Therapist
1509NEMDPhysical Therapy Assistant
001969IAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthowest LLC Physician Assistant CurrentSince Jul 6, 2015 Accepting new patients
Orthowest LLC Physician Assistant CurrentSince Jul 6, 2015 Accepting new patients
Fremont Health Clinic Physician Assistant CurrentSince Feb 4, 2018 Accepting new patients
Northwest Iowa Hospital Corporation Past Accepting new patients
Creighton University Past Accepting new patients
Diagnostic Radiology PC PastSince Sep 10, 2023 Accepting new patients
Alegent Creighton Clinic Physician Assistant Past Accepting new patients

Locations

450 E 23rd St
Fremont, NE 68025
Phone (402) 721-1610

2725 S 144th St
Ste 212
Omaha, NE 68144
Phone (402) 354-4000

Interoperability endpoints

  • Direct secure messaging: bmutize47200@achce.catholichealth.net

Organizations & group practices 8

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 6

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": "1231891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1750528733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7261 MERCY RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242311",
            "telephone_number": "402-398-6248",
            "fax_number": "402-829-8513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 S 144TH ST STE 212",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681445253",
            "telephone_number": "402-637-0800",
            "fax_number": "402-637-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTIZE",
        "first_name": "BATSIRAI",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-14",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1509",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "onclinic@orthonebraska.cernerdirect.com",
            "affiliation": "N",
            "address_1": "2725 S 144th St Ste 212",
            "city": "Omaha",
            "state": "NE",
            "country_code": "US",
            "postal_code": "681445253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.