Individual provider Active NPI

Andrew J Haggerty, PA-C

  • Physician Assistant
  • Papillion, NE
National Provider Identifier
1902512924
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2864 Issued in NE
Practice address
11109 S 84TH St Ste 1820
Papillion, NE 68046-4133
Phone
(402) 827-1577
NPI assigned
Jan 24, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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 2864 NE Primary

Addresses

Primary practice location

11109 S 84TH St Ste 1820
Papillion, NE 68046-4133

Mailing address

7261 Mercy Rd
Omaha, NE 68124-2311

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230322001940 NE Practitioner - Physician Assistant 0143694745 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Creighton University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians

Practice addresses (Care Compare)

11109 S 84TH St
Suite 5800
Papillion, NE 68046-4124
Phone (402) 827-4900

1601 N 86TH St
100 CHI Health Clinic
Lincoln, NE 68505-3713
Phone (402) 328-7500

16909 Lakeside Hills CT
Omaha, NE 68130-4661

Hospital & facility affiliations

  • CHI Health Bergan Mercy Hospital, Omaha, NE, CCN 280060
  • CHI Health Midlands Hospital, Papillion, NE, CCN 280105

National Provider Directory

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

Practice roles

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

Locations

2771 Solution Ctr
Chicago, IL 60677

7261 Mercy Rd
Omaha, NE 68124
Phone (402) 398-6248

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

11109 S 84th St
Ste 1820
Papillion, NE 68046
Phone (402) 827-1577

11109 S 84th St
Ste 5800
Papillion, NE 68046
Phone (402) 827-1577

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.

Hospital & facility affiliations 3

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": "1674518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1902512924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7261 MERCY RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11109 S 84TH ST STE 1820",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680464133",
            "telephone_number": "402-827-1577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGGERTY",
        "first_name": "ANDREW",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-24",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "2864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Papillion, NE

Sources for this page

Verify at the official NPI Registry.