NPIMap

Individual provider Active NPI

Karen S Staack, M.D.

  • Family Medicine Physician
  • Gretna, NE
National Provider Identifier
1831161587
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
21481 Issued in NE
Practice address
102 W Gruenther Rd
Gretna, NE 68028-4828
Phone
(402) 332-2772
Fax
(402) 332-5446
NPI assigned
Feb 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 21481 NE Primary

Addresses

Primary practice location

102 W Gruenther Rd
Gretna, NE 68028-4828

Mailing address

102 W Gruenther Rd
Gretna, NE 68028-4828
Phone (402) 332-2772

Other identifiers 4

IdentifierTypeStateIssuer
1831161587OtherNPI
0550095OtherIAMEDIPASS
470710146-13MedicaidNE
21481OtherNELICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091023000367 NE Practitioner - Family Practice 4789762600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Creighton University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians

Practice addresses (Care Compare)

102 W Gruenther Rd
Gretna, NE 68028-4828
Phone (402) 332-2772

Hospital & facility affiliations

  • CHI Health at Home - Omaha Home health agency, Omaha, NE, CCN 287019
  • Brookestone Home Health Care Home health agency, Elkhorn, NE, CCN 287154
  • CHI Health Bergan Mercy Hospital, Omaha, NE, CCN 280060
  • CHI Health Lakeside Hospital, Omaha, NE, CCN 280130
  • CHI Health Midlands Hospital, Papillion, NE, CCN 280105
  • CHI Health Immanuel Hospital, Omaha, NE, CCN 280081

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21481NEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Skyline Medical Center, P.C. Current Accepting new patients
Alegent Creighton Clinic Family Medicine CurrentSince Oct 1, 2009 Accepting new patients
Alegent Creighton Clinic Family Medicine Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

2771 Solution Ctr
Chicago, IL 60677

1908 N 203rd St
Ste 2
Elkhorn, NE 68022
Phone (402) 289-4031

102 W Gruenther Rd
Gretna, NE 68028
Phone (402) 332-2772

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

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

Interoperability endpoints

  • Direct secure messaging: kstaack8533@achce.catholichealth.net

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 7

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": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1831161587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 W GRUENTHER RD",
            "city": "GRETNA",
            "state": "NE",
            "postal_code": "680284828",
            "telephone_number": "402-332-2772",
            "fax_number": "402-332-5446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W GRUENTHER RD",
            "city": "GRETNA",
            "state": "NE",
            "postal_code": "680284828",
            "telephone_number": "402-332-2772",
            "fax_number": "402-332-5446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAACK",
        "first_name": "KAREN",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-06",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "21481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1831161587",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDIPASS",
            "identifier": "0550095",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "470710146-13",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "21481",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gretna, NE

Sources for this page

Verify at the official NPI Registry.