Kyle Rotherham, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

2867 Issued in NE

Practice address

8005 Farnam Dr Ste 305
Omaha, NE 68114-3426

Phone

(402) 390-4111

Fax

(402) 390-4115

NPI assigned

Jan 2, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in IA, NE2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Creighton University School of Medicine, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MD West One PCGroup PAC ID 0446228852, 89 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Nebraska Methodist Hospital Hospital, Omaha, NE, CCN 280040
• Midwest Surgical Hospital LLC Hospital, Omaha, NE, CCN 280131

Merit-based Incentive Payment System (MIPS)

Final score

84.57 of 100Reported as group

Quality

76.1

Promoting interoperability

95

Improvement activities

40

Cost

76.63

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• MD West One, PC

  • Neurological Surgery Physician
  • Omaha, NE
  • NPI 1588616767

  IA, Physician Assistant

  Medicare reassignment Care Compare group NPD
• MD West One, PC

  • Durable Medical Equipment & Medical Supplies
  • Elkhorn, NE
  • NPI 1740933530
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Midwest Surgical Hospital, L.L.C.

  • Special Hospital
  • Omaha, NE
  • NPI 1013122571
  Care Compare affiliation
• Nebraska Methodist Hospital

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1427147883
  Care Compare affiliation

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

{
    "created_epoch": "1672617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1780397018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8005 FARNAM DR STE 305",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681143426",
            "telephone_number": "402-390-4111",
            "fax_number": "402-390-4115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8005 FARNAM DR STE 305",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681143426",
            "telephone_number": "402-390-4111",
            "fax_number": "402-390-4115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHERHAM",
        "first_name": "KYLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-02",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NE",
            "license": "2867",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1204103",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "2867",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "118173",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vincent Van Rothe, D.D.S.
• Bonnie J Rothell, APRN
• Jadyn Rother
• Jennifer M Rother, PHARMD
• Larisa Rother
• Erika L Rothgeb
• Julie Rothlisberger-Castillo, M.D.
• Nicholas Keith Rothlisberger
• Amanda Rothstein
• Lauren Rottinghaus

• Surgical Physician Assistant in Omaha, NE
• Providers in Omaha, NE by specialty
• Surgical Physician Assistant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.