Individual provider Active NPI

Anthony Robert Mann, PA-C

  • Surgical Physician Assistant
  • Elkhorn, NE
National Provider Identifier
1801150511
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
1665 Issued in NE
Practice address
222 N 192ND St
Elkhorn, NE 68022-5363
Phone
(402) 390-4111
Fax
(402) 390-4115
NPI assigned
Jun 27, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 1665 NE Primary

Addresses

Primary practice location

222 N 192ND St
Elkhorn, NE 68022-5363

Mailing address

8005 Farnam Dr Ste 305
Omaha, NE 68114-3426
Phone (402) 390-4111

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
I20120806000483 NE Practitioner - Physician Assistant 3870749989 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
MD West One PCGroup PAC ID 0446228852, 89 clinicians

Practice addresses (Care Compare)

222 N 192ND St
Elkhorn, NE 68022-2811
Phone (402) 390-4111

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
MD West One, PC Surgical CurrentSince Nov 17, 2025 Accepting new patients
MD West One, PC CurrentSince Nov 17, 2025 Accepting new patients

Locations

222 N 192nd St
Elkhorn, NE 68022

3301 E Elkhorn Dr
Ste 100
Fremont, NE 68025
Phone (402) 721-0090

8005 Farnam Dr
Ste 305
Omaha, NE 68114

5908 S 142nd St
Omaha, NE 68137
Phone (402) 354-1900

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1801150511",
    "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": "222 N 192ND ST",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680225363",
            "telephone_number": "402-390-4111",
            "fax_number": "402-390-4115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "ANTHONY",
        "middle_name": "ROBERT",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-27",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NE",
            "license": "1665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhorn, NE

Sources for this page

Verify at the official NPI Registry.