Individual provider Active NPI

Erik Thor Otterberg, MD

  • Orthopaedic Surgery Physician
  • Omaha, NE
National Provider Identifier
1831157536
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
21337 Issued in NE
Practice address
8005 Farnam Dr Ste 305
Omaha, NE 68114-3426
Phone
(402) 390-4111
Fax
(402) 390-4115
NPI assigned
May 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 21337 NE
Orthopaedic Surgery Physician 207X00000X 21337 NE Primary

Addresses

Primary practice location

8005 Farnam Dr Ste 305
Omaha, NE 68114-3426

Mailing address

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

Other identifiers 6

IdentifierTypeStateIssuer
09-00253OtherNESHARE ADVANTAGE/MERCY RD
09-01143OtherNESHARE ADVANTAGE/ LAKESIDE
0530154MedicaidIA
35110OtherNEMIDLANDS CHOICE
47063010113MedicaidNE
03733OtherNEBCBS OF NEBRASKA

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: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060116000321 NE Practitioner - Orthopedic Surgery 0749204915 Reassigns benefits to 1 organization
I20210331001010 IA Practitioner - Orthopedic Surgery 0749204915 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Michigan Medical School, 1992
Medicare assignment
May accept Medicare assignment
Group practices
Shenandoah Medical CenterGroup PAC ID 9436063237, shared by 7 NPIs, 52 clinicians
MD West One PCGroup PAC ID 0446228852, 89 clinicians
Sports Rehab and Professional Therapy Associates IncGroup PAC ID 1658289608, 124 clinicians

Practice addresses (Care Compare)

1 Jack Foster Dr
Shenandoah, IA 51601-4586
Phone (712) 246-7240

17030 Lakeside Hills PLZ
Suite 110
Omaha, NE 68130-2396
Phone (402) 758-5120

300 Pershing Ave
Shenandoah, IA 51601-2355
Phone (712) 246-1230

315 W 5TH St
Storm Lake, IA 50588-1743
Phone (712) 732-7724

7915 Farnam Dr
Omaha, NE 68114-4504
Phone (402) 399-1900

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

8303 Dodge St
Omaha, NE 68114-4108
Phone (402) 354-4000

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Omaha, NE, CCN 287038
  • Midwest Surgical Hospital LLC Hospital, Omaha, NE, CCN 280131
  • The Nebraska Methodist Hospital Hospital, Omaha, NE, CCN 280040
  • Shenandoah Medical Center Hospital, Shenandoah, IA, CCN 161366
  • CHI Health Lakeside Hospital, Omaha, NE, CCN 280130
  • CHI Health Immanuel Hospital, Omaha, NE, CCN 280081

Merit-based Incentive Payment System (MIPS)

Final score
84.57 of 100Reported as group
Quality
76.1
Promoting interoperability
95
Improvement activities
40
Cost
76.63

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement52
Knee replacement77
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21337NEMDAdult Reconstructive Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shenandoah Medical Center Current Accepting new patients
MD West One, PC Orthopaedic Surgery CurrentSince Jul 1, 2017 Accepting new patients
Shenandoah Medical Center Current Accepting new patients
Shenandoah Medical Center CurrentSince Sep 1, 2024 Accepting new patients
Shenandoah Medical Center CurrentSince Sep 1, 2024 Accepting new patients
MD West One, PC Orthopaedic Surgery CurrentSince Jul 1, 2017 Accepting new patients

Locations

1 Edmundson Pl
Ste 200
Council Bluffs, IA 51503
Phone (712) 243-3250

2959 US Highway 275
Hamburg, IA 51640
Phone 71238215158070

1 Jack Foster Dr
Shenandoah, IA 51601
Phone (712) 246-7240

300 Pershing Ave
Shenandoah, IA 51601
Phone (712) 246-1230

222 N 192nd St
Elkhorn, NE 68022

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

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

7710 Mercy Rd
Ste 224
Omaha, NE 68124
Phone (402) 399-8550

8005 Farnam Dr
Ste 305
Omaha, NE 68114

Organizations & group practices 7

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 6

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": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1831157536",
    "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": "8005 FARNAM DR STE 305",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681143426",
            "telephone_number": "402-390-4111",
            "fax_number": "402-390-4115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTERBERG",
        "first_name": "ERIK",
        "middle_name": "THOR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "NE",
            "license": "21337",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NE",
            "license": "21337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SHARE ADVANTAGE/MERCY RD",
            "identifier": "09-00253",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SHARE ADVANTAGE/ LAKESIDE",
            "identifier": "09-01143",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0530154",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "35110",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47063010113",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NEBRASKA",
            "identifier": "03733",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.