NPIMap

Individual provider Active NPI

Kallie Roberts, D.O.

  • Vascular Surgery Physician
  • Lincoln, NE
National Provider Identifier
1831559228
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
2819 Issued in NE
Practice address
7500 S 91St St
Lincoln, NE 68526-9437
Phone
(402) 327-2700
NPI assigned
Feb 29, 2016
Last updated
Aug 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OH
Vascular Surgery Physician 2086S0129X 2819 NE Primary

Addresses

Primary practice location

7500 S 91St St
Lincoln, NE 68526-9437

Mailing address

7500 S 91St St
Lincoln, NE 68526-9437
Phone (402) 327-2700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, KS2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230822001980 NE Practitioner - Vascular Surgery 5395011068 Reassigns benefits to 3 organizations
I20240301003223 KS Practitioner - Vascular Surgery 5395011068 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CHI Health Clinic Specialty LLCGroup PAC ID 4789098443, 317 clinicians

Practice addresses (Care Compare)

Smith Center, KS 66967
Phone (785) 282-6845

7440 S 91St St
Lincoln, NE 68526-9797

7500 S 91St St
CHI Health Nebraska Heart
Lincoln, NE 68526-9437
Phone (402) 327-2700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
33.1 of 100Reported as group
Quality
0
Promoting interoperability
100
Improvement activities
0
Cost
27.01

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Leg revascularization (restoring blood flow)14
Removal of tissue53

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
CHI Health Clinic Specialty, LLC CurrentSince Sep 19, 2023 Accepting new patients
St. Mary's Community Hospital CurrentSince Feb 1, 2024 Accepting new patients
St. Mary's Community Hospital CurrentSince Feb 1, 2024 Accepting new patients
The Physician Network PastSince Sep 1, 2011 Accepting new patients
Nebraska Heart Hospital Past Accepting new patients

Locations

614 S Main St
Smith Center, KS 66967
Phone (785) 282-6845

555 S 70th St
Lincoln, NE 68510
Phone (402) 219-8000

7440 S 91st St
Lincoln, NE 68526
Phone (402) 489-6554

7500 S 91st St
Lincoln, NE 68526
Phone (402) 327-2700

8207 Northwoods Dr
Ste 100
Lincoln, NE 68505
Phone (402) 484-3440

1301 Grundman Blvd
Nebraska City, NE 68410
Phone (402) 713-0110

1301 Grundman Blvd
Ste A
Nebraska City, NE 68410
Phone (402) 873-3321

Organizations & group practices 5

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 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": "1456704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1831559228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 S 91ST ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685269437",
            "telephone_number": "402-327-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 S 91ST ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685269437",
            "telephone_number": "402-327-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "KALLIE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-29",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NE",
            "license": "2819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.