Individual provider Active NPI

Craig A Bassett, M.D.

  • Obstetrics & Gynecology Physician
  • Elkhorn, NE
National Provider Identifier
1912010950
Registry record updated Jun 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
12833 Issued in NE
Practice address
717 N 190TH PLZ
Ste. # 1100
Elkhorn, NE 68022-3917
Phone
(402) 815-1700
Fax
(402) 815-1959
NPI assigned
Aug 16, 2006
Last updated
Jun 30, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 12833 NE Primary
Obstetrics & Gynecology Physician 207V00000X 22384 IA

Addresses

Primary practice location

717 N 190TH PLZ
Ste. # 1100
Elkhorn, NE 68022-3917

Mailing address

PO Box 3755
Omaha, NE 68103-0755
Phone (402) 354-2100

Other identifiers 6

IdentifierTypeStateIssuer
10025350400MedicaidNE
1912010950MedicaidIA
47068731795MedicaidNE
47068731742MedicaidNE
47068731799MedicaidNE
10026301600MedicaidNE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051004000378 NE Practitioner - Obstetrics/Gynecology 0941235436 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12833NEMDMental Health Counselor
22384IAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Clinic Inc Obstetrics & Gynecology CurrentSince Jan 31, 1996 Accepting new patients
Radiologic Center Inc PastSince Jan 31, 1996 Accepting new patients

Locations

717 N 190th Plz
Ste 1100
Elkhorn, NE 68022
Phone (402) 815-1700

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

825 S 169th St
Fl 3
Omaha, NE 68118
Phone (402) 354-5451

8901 W Dodge Rd
Ste 100
Omaha, NE 68114
Phone (402) 354-1700

101 E Centennial Rd
Papillion, NE 68046
Phone (402) 354-7750

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

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435622400000",
    "number": "1912010950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3755",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681030755",
            "telephone_number": "402-354-2100",
            "fax_number": "402-354-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 N 190TH PLZ",
            "address_2": "STE. # 1100",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680223917",
            "telephone_number": "402-815-1700",
            "fax_number": "402-815-1959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASSETT",
        "first_name": "CRAIG",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2015-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NE",
            "license": "12833",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IA",
            "license": "22384",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025350400",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1912010950",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47068731795",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47068731742",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47068731799",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026301600",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhorn, NE

Sources for this page

Verify at the official NPI Registry.