NPIMap

Individual provider Active NPI

Angela Blane Chambers, PA-C

  • Medical Physician Assistant
  • Omaha, NE
National Provider Identifier
1790972719
Registry record updated Jul 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2003 Issued in NE
Practice address
12856 Deauville Dr
Omaha, NE 68137-3204
Phone
(402) 895-2266
NPI assigned
Oct 3, 2007
Last updated
Jul 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2003 NE Primary

Addresses

Primary practice location

12856 Deauville Dr
Omaha, NE 68137-3204

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

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
I20160427001038 NE Practitioner - Physician Assistant 3274623558 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bloomfield Medical Clinic, PCGroup PAC ID 5890877831, 4 clinicians
Alegent Creighton HealthGroup PAC ID 1850285255, 137 clinicians

Practice addresses (Care Compare)

105 S Broadway St
Bloomfield, NE 68718-4419
Phone (402) 373-4341

402 N Maple St
Osmond General Hospital
Osmond, NE 68765-5726
Phone (402) 748-3393

406 N Maple St
Osmond, NE 68765-5726
Phone (402) 748-3393

704 N 3Rd St
Plainview, NE 68769-2047
Phone (402) 582-4245

PO Box
Suite 357
Bloomfield, NE 68718-0357

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2003NEMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Osmond General Hospital Inc CurrentSince Mar 31, 2019 Accepting new patients
Alegent Creighton Health CurrentSince Oct 21, 2019 Accepting new patients
Alegent Creighton Health CurrentSince Oct 21, 2019 Accepting new patients
Osmond General Hospital Inc CurrentSince Mar 31, 2019 Accepting new patients
Horizon Health Care, Inc Past Accepting new patients

Locations

2771 Solution Ctr
Chicago, IL 60677

704 N 3rd St
Plainview, NE 68769
Phone (402) 582-3434

Interoperability endpoints

  • Direct secure messaging: angela.chambers@avera.sdhealthlink.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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1790972719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12856 DEAUVILLE DR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681373204",
            "telephone_number": "402-895-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERS",
        "first_name": "ANGELA",
        "middle_name": "BLANE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-03",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "2003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.