Active NPI
Michael Scott Hermsen, DDS
- Endodontics
- Omaha, NE
National Provider Identifier
1871740340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 6510
- Practice address
- 615 N 90TH St
Omaha, NE 68114-2821 - Phone
- (402) 393-5050
- Fax
- (402) 393-3401
- NPI assigned
- Aug 26, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 6510 | NE | Primary |
Addresses
Primary practice location
615 N 90TH St
Omaha, NE 68114-2821
Mailing address
615 N 90TH St
Omaha, NE 68114-2821
Phone (402) 393-5050
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jul 24, 2015 through Jul 24, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6510 | NE | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Heartland Endodontic Specialists, LLC | Endodontics | Past | Accepting new patients |
| Great Plains Dental Specialists P.C. | Endodontics | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Endodontics
- Omaha, NE
- NPI 1871690842
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219708800000",
"number": "1871740340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 N 90TH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681142821",
"telephone_number": "402-393-5050",
"fax_number": "402-393-3401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 N 90TH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681142821",
"telephone_number": "402-393-5050",
"fax_number": "402-393-3401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERMSEN",
"first_name": "MICHAEL",
"middle_name": "SCOTT",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-08-26",
"last_updated": "2008-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "NE",
"license": "6510",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.