Individual provider Active NPI

Emily J Mayberger, PA-C

  • Physician Assistant
  • Omaha, NE
National Provider Identifier
1871208306
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2851 Issued in NE
Practice address
4350 Dewey Ave
Omaha, NE 68105-1017
Phone
(402) 552-2000
NPI assigned
Jan 19, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2851 NE Primary

Addresses

Primary practice location

4350 Dewey Ave
Omaha, NE 68105-1017

Mailing address

4350 Dewey Ave # Ne68105
Omaha, NE 68105-1017
Phone (402) 552-2000

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
I20230131003342 NE Practitioner - Physician Assistant 7810368743 Reassigns benefits to 2 organizations
I20230201000122 IA Practitioner - Physician Assistant 7810368743 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unmc PhysiciansGroup PAC ID 6002728391, 1,490 clinicians

Practice addresses (Care Compare)

17617 Burke St
Omaha, NE 68118-2259
Phone (402) 596-4000

4014 Leavenworth St
Omaha, NE 68105-1053
Phone (402) 552-7928

987400 Nebraska Medical Ctr
Unmc Physicians Nebraska Medical Center
Omaha, NE 68198-7400
Phone (402) 559-4000

Emile 42ND St
Omaha, NE 68198-0001
Phone (402) 559-4015

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2851NEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic CurrentSince Mar 21, 2023 Accepting new patients
Alegent Creighton Clinic CurrentSince Mar 21, 2023 Accepting new patients
Alegent Creighton Clinic Physician Assistant CurrentSince Mar 21, 2023 Accepting new patients

Locations

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

800 Mercy Dr
Council Bluffs, IA 51503
Phone (712) 328-5000

2771 Solution Ctr
Chicago, IL 60677

7500 Mercy Rd
Omaha, NE 68124
Phone (402) 398-5880

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

Interoperability endpoints

  • Direct secure messaging: emayberger206834@direct.nebraskamed.com

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 1

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": "1674086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1871208306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 DEWEY AVE # NE68105",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681051017",
            "telephone_number": "402-552-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 DEWEY AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681051017",
            "telephone_number": "402-552-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYBERGER",
        "first_name": "EMILY",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-19",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "2851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.