Individual provider Active NPI

Kathrine Rose Ruffalo, PA-C

  • Physician Assistant
  • Omaha, NE
National Provider Identifier
1821774423
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3222 Issued in NE
Practice address
7710 Mercy Rd Ste 3000
Omaha, NE 68124-2350
Phone
(402) 932-1999
Fax
(402) 932-1948
NPI assigned
Jun 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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 131213 IA
Physician Assistant 363A00000X 3222 NE Primary

Addresses

Primary practice location

7710 Mercy Rd Ste 3000
Omaha, NE 68124-2350

Mailing address

7261 Mercy Rd
Omaha, NE 68124-2311

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
I20250503000128 NE Practitioner - Physician Assistant 7618494659 Reassigns benefits to 1 organization
I20251208000599 IA Practitioner - Physician Assistant 7618494659 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
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)

16901 Lakeside Hills CT
Omaha, NE 68130-2318
Phone (855) 524-4001

16909 Lakeside Hills CT
Omaha, NE 68130-4661

17030 Lakeside Hills PLZ
Suite 204
Omaha, NE 68130-2396
Phone (402) 758-5600

631 N 8TH St
Missouri Valley, IA 51555-1102
Phone (712) 642-2784

7500 Mercy Rd
Omaha, NE 68124-2319
Phone (402) 398-5580

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3222NEMDDental Hygienist
131213IAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Health Community Memorial Hospital of Missouri Valley Iowa CurrentSince Nov 17, 2025 Accepting new patients
Alegent Creighton Clinic Physician Assistant CurrentSince Nov 17, 2025 Accepting new patients
Alegent Creighton Clinic CurrentSince May 20, 2025 Accepting new patients
Alegent Health Community Memorial Hospital of Missouri Valley, Iowa CurrentSince Nov 17, 2025 Accepting new patients

Locations

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

809 Elm St
Missouri Vly, IA 51555
Phone (712) 642-2794

631 N 8th St
Mo Valley, IA 51555
Phone (712) 642-2045

2771 Solution Ctr
Chicago, IL 60677

7710 Mercy Rd
Ste 3000
Omaha, NE 68124
Phone (402) 717-9600

17030 Lakeside Hills Plz
Ste 200
Omaha, NE 68130
Phone (402) 399-8550

7261 Mercy Rd
Omaha, NE 68124
Phone (402) 398-6248

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

Organizations & group practices 4

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": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1821774423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7261 MERCY RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7710 MERCY RD STE 3000",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242350",
            "telephone_number": "402-932-1999",
            "fax_number": "402-932-1948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUFFALO",
        "first_name": "KATHRINE",
        "middle_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-27",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "131213",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "3222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.