Individual provider Active NPI

Mindy Keane, PA-C

  • Surgical Physician Assistant
  • Omaha, NE
National Provider Identifier
1871951327
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
1987 Issued in NE
Practice address
8005 Farnam Dr Ste 305
Omaha, NE 68114-3426
Phone
(402) 390-4111
Fax
(402) 390-4115
NPI assigned
Jan 29, 2016
Last updated
Oct 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1987 NE
Surgical Physician Assistant 363AS0400X 1987 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 practice location 1

222 N 192nd St
Elkhorn, NE 68022-5363
Phone (402) 390-4111

Other identifiers 3

IdentifierTypeStateIssuer
47068731751MedicaidNE
1871954327MedicaidIA
47068731742MedicaidNE

Other names 1

  • Mindy Moody Former name

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
I20160205000119 NE Practitioner - Physician Assistant 4082918495 Reassigns benefits to 3 organizations
I20210405000080 IA Practitioner - Physician Assistant 4082918495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MD West One PCGroup PAC ID 0446228852, 89 clinicians

Practice addresses (Care Compare)

1 Edmundson PL
Suite 200
Council Bluffs, IA 51503-4658
Phone (402) 390-4111

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

5908 S 142ND St
Omaha, NE 68137-2800
Phone (402) 390-4111

7500 Mercy Rd
Omaha, NE 68124-2319
Phone (402) 398-6060

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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
MD West One, PC Physician Assistant CurrentSince Mar 1, 2020 Accepting new patients
MD West One, PC CurrentSince Mar 1, 2020 Accepting new patients
Physicians Clinic Inc Physician Assistant CurrentSince Jul 17, 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 (316) 644-5393

222 N 192nd St
Elkhorn, NE 68022

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

10060 Regency Cir
Omaha, NE 68114
Phone (402) 354-1405

16120 W Dodge Rd
Omaha, NE 68118
Phone (402) 354-0550

8005 Farnam Dr
Ste 305
Omaha, NE 68114

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1454025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1871951327",
    "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": [
        {
            "address_1": "222 N 192nd St",
            "address_purpose": "LOCATION",
            "city": "Elkhorn",
            "state": "NE",
            "postal_code": "680225363",
            "country_code": "US",
            "telephone_number": "402-390-4111",
            "fax_number": "402-390-4115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEANE",
        "first_name": "MINDY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-29",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1987",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NE",
            "license": "1987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47068731751",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1871954327",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47068731742",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MINDY",
            "last_name": "MOODY",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.