Individual provider Active NPI

Laura Jane Dart, PA

  • Physician Assistant
  • Omaha, NE
National Provider Identifier
1811910912
Registry record updated Mar 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1604 Issued in NE
Practice address
16101 Evans St
Omaha, NE 68116-2020
Phone
(402) 717-9700
Fax
(402) 717-9701
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1604 NE Primary
Physician Assistant 363A00000X 076377 IA

Addresses

Primary practice location

16101 Evans St
Omaha, NE 68116-2020

Mailing address

PO Box 642117
Omaha, NE 68164-8117
Phone (402) 398-6254

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20141219000958 NE Practitioner - Physician Assistant 7416102793 Reassigns benefits to 1 organization
I20150323001987 IA Practitioner - Physician Assistant 7416102793 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton ClinicGroup PAC ID 1951210418, shared by 2 NPIs, 951 clinicians

Practice addresses (Care Compare)

16101 Evans St
Omaha, NE 68116-6447
Phone (402) 717-9700

1625 N 205TH St
CHI Health Clinic
Elkhorn, NE 68022-4759
Phone (402) 758-5452

16909 Lakeside Hills CT
Omaha, NE 68130-4661

3135 W Broadway
Council Bluffs, IA 51501-3359
Phone (712) 328-9100

4220 L St
Suite 100
Omaha, NE 68107-1048
Phone (402) 733-4433

5045 S 153Rd St
Omaha, NE 68137-5001
Phone (402) 717-9100

6801 Newport Ave
Omaha, NE 68152-2152
Phone (402) 572-3900

800 Mercy Dr
Council Bluffs, IA 51503-3128

8141 W Ctr
Omaha, NE 68124-3273
Phone (402) 717-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1604NEMDMental Health Counselor
076377IAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic CurrentSince Jan 13, 2015 Accepting new patients
Alegent Creighton Clinic Physician Assistant CurrentSince Apr 1, 2015 Accepting new patients

Locations

800 Mercy Dr
Ste 220
Council Bluffs, IA 51503
Phone (712) 388-2660

2771 Solution Ctr
Chicago, IL 60677

16909 Lakeside Hills Ct
Ste 401
Omaha, NE 68130
Phone (402) 827-4920

16101 Evans St
Omaha, NE 68116
Phone (402) 717-9700

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426723200000",
    "number": "1811910912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 642117",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681648117",
            "telephone_number": "402-398-6254",
            "fax_number": "402-829-8513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16101 EVANS ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681162020",
            "telephone_number": "402-717-9700",
            "fax_number": "402-717-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DART",
        "first_name": "LAURA",
        "middle_name": "JANE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2015-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1604",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "076377",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.