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Individual provider Active NPI

Ailene A Nielsen, APRNC

  • Nurse Practitioner
  • Omaha, NE
National Provider Identifier
1770542839
Registry record updated Jun 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
110287 Issued in NE
Practice address
1120 N 103Rd PLZ
Suite 100
Omaha, NE 68114-1114
Phone
(402) 391-5055
Fax
(402) 391-5053
NPI assigned
Mar 18, 2006
Last updated
Jun 12, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 110287 NE Primary

Addresses

Primary practice location

1120 N 103Rd PLZ
Suite 100
Omaha, NE 68114-1114

Mailing address

PO Box 3755
Omaha, NE 68103-0755
Phone (402) 354-2100

Other identifiers 2

IdentifierTypeStateIssuer
1770542839MedicaidIA
100264481-00MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20260513000719 MN Practitioner - Nurse Practitioner 2668427519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs Medical CenterGroup PAC ID 8224948443, 238 clinicians

Practice addresses (Care Compare)

2024 S 6TH St
Brainerd, MN 56401-4529
Phone (218) 828-7100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Clinic Inc Nurse Practitioner CurrentSince Dec 31, 2014 Accepting new patients

Locations

1 Edmundson Pl
Council Bluffs, IA 51503
Phone (712) 396-4000

1 Edmundson Pl
Ste 306
Council Bluffs, IA 51503
Phone (712) 396-4295

426 E 22nd St
Ste 100
Fremont, NE 68025
Phone (402) 727-7796

10060 Regency Cir
Omaha, NE 68114
Phone (402) 354-1405

1120 N 103rd Plz
Ste 100
Omaha, NE 68114
Phone (402) 391-5055

6901 N 72nd St
Ste 3300N
Omaha, NE 68122
Phone (402) 572-3300

825 S 169th St
Fl 3
Omaha, NE 68118
Phone (402) 354-5451

Organizations & group practices 2

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 11

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": "1142640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434067200000",
    "number": "1770542839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3755",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681030755",
            "telephone_number": "402-354-2100",
            "fax_number": "402-354-6171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 N 103RD PLZ",
            "address_2": "SUITE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681141114",
            "telephone_number": "402-391-5055",
            "fax_number": "402-391-5053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "AILENE",
        "middle_name": "A",
        "credential": "APRNC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-18",
        "last_updated": "2015-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NE",
            "license": "110287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770542839",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100264481-00",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.