Individual provider Active NPI

Jesse Tyndall, MPAS

  • Physician Assistant
  • Hastings, NE
National Provider Identifier
1801141866
Registry record updated Jul 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1666 Issued in NE
Practice address
2727 W 2ND St # 340
Hastings, NE 68901-4684
Phone
(402) 463-1250
NPI assigned
Jul 16, 2012
Last updated
Jul 16, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1666 NE Primary

Addresses

Primary practice location

2727 W 2ND St # 340
Hastings, NE 68901-4684

Mailing address

2727 W 2ND St # 340
Hastings, NE 68901-4684
Phone (402) 463-1250

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
I20130121000129 NE Practitioner - Physician Assistant 7416100656 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CHI Health Clinic Specialty LLCGroup PAC ID 4789098443, 317 clinicians

Practice addresses (Care Compare)

7440 S 91St St
Lincoln, NE 68526-9797

8207 Northwoods Dr
Suite 100
Lincoln, NE 68505-2093
Phone (402) 484-3440

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1666NEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Physician Network PastSince Sep 1, 2011 Accepting new patients

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 2

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": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342396800000",
    "number": "1801141866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 W 2ND ST # 340",
            "city": "HASTINGS",
            "state": "NE",
            "postal_code": "689014684",
            "telephone_number": "402-463-1250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 W 2ND ST # 340",
            "city": "HASTINGS",
            "state": "NE",
            "postal_code": "689014684",
            "telephone_number": "402-463-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYNDALL",
        "first_name": "JESSE",
        "credential": "MPAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-16",
        "last_updated": "2012-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hastings, NE

Sources for this page

Verify at the official NPI Registry.