Individual provider Active NPI

Kristie D Hayes, MD

  • Dermatology Physician
  • Omaha, NE
National Provider Identifier
1902855257
Registry record updated Nov 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
18245 Issued in NE
Practice address
4014 Leavenworth St
Omaha, NE 68105-1053
Phone
(402) 552-7928
NPI assigned
May 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 18245 NE Primary

Addresses

Primary practice location

4014 Leavenworth St
Omaha, NE 68105-1053

Mailing address

988102 Nebraska Medical Ctr
Omaha, NE 68198-8102

Other identifiers 2

IdentifierTypeStateIssuer
1902855257MedicaidIA
47068731742MedicaidNE

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: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
18245NEMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unmc Physicians CurrentSince Nov 11, 2019 Accepting new patients
Braddock Finnegan Helget Dermatology, P.C. Past Accepting new patients

Locations

Emile 42nd St
Omaha, NE 68198
Phone (402) 552-6731

988102 Nebraska Medical Ctr
Omaha, NE 68198
Phone (402) 559-5600

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.

NPI Registry JSON

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

{
    "created_epoch": "1146873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1902855257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988102 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681988102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4014 LEAVENWORTH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681051053",
            "telephone_number": "402-552-7928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYES",
        "first_name": "KRISTIE",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-06",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NE",
            "license": "18245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902855257",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47068731742",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.