Martin N Katambwa, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

2036 Issued in NE

Practice address

812 N 22ND St
Blair, NE 68008-1128

Phone

(402) 426-4611

Fax

(402) 426-4642

NPI assigned

Feb 21, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• North Platte Nebraska Hospital Corporation

  • General Acute Care Hospital
  • North Platte, NE
  • NPI 1700855533
  Medicare reassignment NPD
• North Platte Nebraska Hospital Corporation

  • Medical Oncology Physician
  • North Platte, NE
  • NPI 1134355332
  NPD
• Decatur Emergency Medical Services II S C

  • Emergency Medical Services (Emergency Medicine) Physician
  • Decatur, IL
  • NPI 1699881508
  NPD (past)
• Dr. Wit Internal Medicine Prof Geriatric Care

  • Geriatric Medicine (Internal Medicine) Physician
  • Saint Louis, MO
  • NPI 1033194386
  NPD (past)
• Emergency Medicine Physicians of Chicago, LLC

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1316178221
  NPD (past)
• Inpatient Consultants of Missouri Inc

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1194779579
  NPD (past)
• Memorial Expresscare, LLC

  • Family Medicine Physician
  • Springfield, IL
  • NPI 1750532362
  NPD (past)
• Old Six Mile Inpatient Services, LLC

  • Internal Medicine Physician
  • Granite City, IL
  • NPI 1285060665
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525046400000",
    "number": "1881669075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 N 206TH ST",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680226992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 N 22ND ST",
            "city": "BLAIR",
            "state": "NE",
            "postal_code": "680081128",
            "telephone_number": "402-426-4611",
            "fax_number": "402-426-4642"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "812 N 22nd St",
            "address_purpose": "LOCATION",
            "city": "Blair",
            "state": "NE",
            "postal_code": "680081128",
            "country_code": "US",
            "telephone_number": "402-426-4611",
            "fax_number": "402-426-4642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KATAMBWA",
        "first_name": "MARTIN",
        "middle_name": "N",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2018-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085004591",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MO",
            "license": "2003004599",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "2036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Robert Jensen, PTA
• Kenna Jensen
• Jamie L Johnson
• Ivan C. Karpisek, D.D.S.
• Penny Karsten
• Stephanie Ann Kessel
• Cameron Kienholz, ATC, LAT, DPT
• Debra Kirchhoff, M.S., CCC-SLP
• Michael Jon Kirwan, CRNA
• Jerilyn Kliewer

• Medical Physician Assistant in Blair, NE
• Providers in Blair, NE by specialty
• Medical Physician Assistant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.