NPIMap

Individual provider Active NPI

Timothy Blecha, MD

  • Family Medicine Physician
  • Superior, NE
National Provider Identifier
1790777936
Registry record updated Sep 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
15972 Issued in NE
Practice address
525 E 11TH St
Superior, NE 68978-1101
Phone
(402) 879-4781
Fax
(402) 879-3365
NPI assigned
Aug 15, 2005
Last updated
Sep 9, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 15972 NE
Emergency Medicine Physician 207P00000X 15972 NE
Family Medicine Physician 207Q00000X 15972 NE Primary

Addresses

Primary practice location

525 E 11TH St
Superior, NE 68978-1101

Mailing address

PO Box 407
525 E 11TH St
Superior, NE 68978-0407
Phone (402) 879-4781

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address TimothyBlecha@bmh.securechart.com Direct

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
I20100218000155 NE Practitioner - Family Practice 9234273988 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Creighton University School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brodstone Memorial HospitalGroup PAC ID 4082513015, shared by 5 NPIs, 12 clinicians

Practice addresses (Care Compare)

520 E 10TH St
Superior, NE 68978-1225
Phone (402) 879-3281

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.6 of 100Reported as apm
Quality
82.13
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15972NEMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brodstone Memorial Hospital Family Medicine CurrentSince Dec 13, 2016 Accepting new patients
Brodstone Memorial Hospital Current Accepting new patients
The Evangelical Lutheran Good Samaritan Society Past Accepting new patients
Brodstone Memorial Hospital Family Medicine Past Accepting new patients

Locations

520 E 10th St
Superior, NE 68978
Phone (402) 224-3344

525 E 11th St
Superior, NE 68978
Phone (402) 879-4781

Interoperability endpoints

  • Direct secure messaging: timothyblecha@bmh.securechart.com

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Brodstone HealthcareSuperior, NE, CCN 281315 Hospital W-2 Managing Employee
Operational/Managerial Control		 May 17, 2024
May 17, 2024
Brodstone HealthcareSuperior, NE, CCN 28Z315 Hospital W-2 Managing Employee
Operational/Managerial Control		 May 17, 2024
May 17, 2024
Brodstone Family Medical Center - NelsonNelson, NE, CCN 283479 Rural health clinic W-2 Managing Employee
Operational/Managerial Control		 Oct 1, 2004
Oct 1, 2004
Brodstone Family Medical Center - SuperiorSuperior, NE, CCN 283478 Rural health clinic W-2 Managing Employee
Operational/Managerial Control		 Oct 1, 2004
Oct 1, 2004
Brodstone Family Medical Center - EdgarEdgar, NE, CCN 283496 Rural health clinic W-2 Managing Employee
Operational/Managerial Control		 Jul 1, 2017
Jul 1, 2017

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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 12

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": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1790777936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 407",
            "address_2": "525 E 11TH ST",
            "city": "SUPERIOR",
            "state": "NE",
            "postal_code": "689780407",
            "telephone_number": "402-879-4781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E 11TH ST",
            "city": "SUPERIOR",
            "state": "NE",
            "postal_code": "689781101",
            "telephone_number": "402-879-4781",
            "fax_number": "402-879-3365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLECHA",
        "first_name": "TIMOTHY",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NE",
            "license": "15972",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NE",
            "license": "15972",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "15972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "TimothyBlecha@bmh.securechart.com",
            "affiliation": "N",
            "endpointDescription": "direct messaging email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "none",
            "address_1": "525 E 11th St",
            "city": "Superior",
            "state": "NE",
            "country_code": "US",
            "postal_code": "689781101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Superior, NE

Sources for this page

Verify at the official NPI Registry.