Individual provider Active NPI

Emily Anna Gofta

  • Medical Physician Assistant
  • Omaha, NE
National Provider Identifier
1801403209
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2541 Issued in NE
Practice address
17241 Oak Dr
Omaha, NE 68130-2428
Phone
(402) 896-1242
NPI assigned
Sep 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

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 2541 NE Primary

Addresses

Primary practice location

17241 Oak Dr
Omaha, NE 68130-2428

Mailing address

1111 Devon Dr
Papillion, NE 68046-3837
Phone (402) 681-8767

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
I20201012000068 NE Practitioner - Physician Assistant 4789004870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Medicine Associates Millard-Gretna P CGroup PAC ID 4981731411, 4 clinicians

Practice addresses (Care Compare)

17241 Oak Dr
Omaha, NE 68130-2202
Phone (402) 896-1242

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2541NEMDSpeech-Language Pathologist

Organizations & group practices 1

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 1

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": "1601337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1801403209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 DEVON DR",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680463837",
            "telephone_number": "402-681-8767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17241 OAK DR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681302428",
            "telephone_number": "402-896-1242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOFTA",
        "first_name": "EMILY",
        "middle_name": "ANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-29",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "2541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.