Individual provider Active NPI

Jessica Lavon Prescott

  • Physician Assistant
  • Omaha, NE
National Provider Identifier
1790404168
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2907 Issued in NE
Practice address
17404 Burke St Ste 102
Omaha, NE 68118-2242
Phone
(531) 466-4260
Fax
(531) 466-4304
NPI assigned
Aug 26, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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 116920 IA
Physician Assistant 363A00000X 2907 NE Primary

Addresses

Primary practice location

17404 Burke St Ste 102
Omaha, NE 68118-2242

Mailing address

17404 Burke St Ste 102
Omaha, NE 68118-2242
Phone (531) 466-4260

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230316002225 NE Practitioner - Physician Assistant 5193199057 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vascular and Interventional Radiology of SiouxlandGroup PAC ID 7113330663, 24 clinicians

Practice addresses (Care Compare)

100 Hospital Dr
Pender, NE 68047-4507
Phone (605) 217-5610

17404 Burke St
Suite 102
Omaha, NE 68118-2242
Phone (531) 466-4260

Hospital & facility affiliations

  • The Nebraska Methodist Hospital Hospital, Omaha, NE, CCN 280040
  • CHI Health Immanuel Hospital, Omaha, NE, CCN 280081
  • CHI Health Mercy Council Bluffs Hospital, Council Bluffs, IA, CCN 160028
  • CHI Health Bergan Mercy Hospital, Omaha, NE, CCN 280060
  • CHI Health Lakeside Hospital, Omaha, NE, CCN 280130

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nebraska Methodist Hospital Current Accepting new patients

Locations

515 N 162nd Ave
Ste 300
Omaha, NE 68118
Phone (402) 354-1200

Interoperability endpoints

  • Direct secure messaging: jessica.prescott@direct.nmhs.org

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.

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": "1661472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1790404168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17404 BURKE ST STE 102",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681182242",
            "telephone_number": "531-466-4260",
            "fax_number": "531-466-4304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17404 BURKE ST STE 102",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681182242",
            "telephone_number": "531-466-4260",
            "fax_number": "531-466-4304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESCOTT",
        "first_name": "JESSICA",
        "middle_name": "LAVON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-26",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "116920",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "2907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.