NPIMap

Individual provider Active NPI

Clayton Bates Schroeder, M.D.

  • Internal Medicine Physician
  • Omaha, NE
National Provider Identifier
1922128602
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
24294 Issued in NE
Practice address
11819 Miracle Hills Dr Ste 105
Omaha, NE 68154-4428
Phone
(402) 356-8601
Fax
(402) 819-0919
NPI assigned
Mar 29, 2007
Last updated
Jul 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 24294 NE Primary

Addresses

Primary practice location

11819 Miracle Hills Dr Ste 105
Omaha, NE 68154-4428

Mailing address

11819 Miracle Hills Dr Ste 105
Omaha, NE 68154-4428
Phone (402) 356-8601

Other identifiers 1

IdentifierTypeStateIssuer
10027852400MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081002000493 NE Practitioner - Internal Medicine 5092883124 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Nebraska College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Clinic IncGroup PAC ID 4880506062, 557 clinicians

Practice addresses (Care Compare)

10060 Regency Cir
Omaha, NE 68114-3732
Phone (402) 354-1570

11819 Miracle Hills Dr
Suite 105
Omaha, NE 68154-4428
Phone (402) 356-8601

8901 W Dodge Rd
Omaha, NE 68114-3327
Phone (402) 390-1200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clayton Schroeder MD PC Internal Medicine CurrentSince Jul 4, 2023 Accepting new patients
Physicians Clinic Inc Internal Medicine CurrentSince Aug 31, 2008 Accepting new patients

Locations

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

11819 Miracle Hills Dr
Ste 105
Omaha, NE 68154
Phone (402) 356-8601

8901 W Dodge Rd
Omaha, NE 68114
Phone (402) 354-8990

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

Interoperability endpoints

  • Direct secure messaging: clayton.schroeder.1@28196.direct.athenahealth.com
  • Direct secure messaging: clayton.schroeder@direct.nmhs.org

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.

Hospital & facility affiliations 9

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": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1922128602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11819 MIRACLE HILLS DR STE 105",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681544428",
            "telephone_number": "402-356-8601",
            "fax_number": "402-819-0919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11819 MIRACLE HILLS DR STE 105",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681544428",
            "telephone_number": "402-356-8601",
            "fax_number": "402-819-0919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROEDER",
        "first_name": "CLAYTON",
        "middle_name": "BATES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "24294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10027852400",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.