Individual provider Active NPI

Mia J. Hyde, P.A.-C

  • Physician Assistant
  • Kearney, NE
National Provider Identifier
1932195161
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
562 Issued in NE
Practice address
816 22ND Ave Ste 100
Kearney, NE 68845-2226
Phone
(308) 865-2263
NPI assigned
Sep 22, 2005
Last updated
Nov 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 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 562 NE Primary

Addresses

Primary practice location

816 22ND Ave Ste 100
Kearney, NE 68845-2226

Mailing address

3016 W. Faidley Ave
Grand Island, NE 68803
Phone (308) 381-8546

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
I20101012000293 NE Practitioner - Physician Assistant 4688866429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bryan Hospital KearneyGroup PAC ID 5991195547, 116 clinicians

Practice addresses (Care Compare)

804 22ND Ave
Kearney, NE 68845-2206
Phone (308) 455-3600

816 22ND Ave
Suite 100
Kearney, NE 68845-2226
Phone (308) 865-2263

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
562NEMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Bryan Hospital Kearney CurrentSince Sep 1, 2022 Accepting new patients
Platte Valley Medical Group, P.C. Past Accepting new patients

Locations

804 22nd Ave
Kearney, NE 68845
Phone (308) 455-3600

816 22nd Ave
Ste 100
Kearney, NE 68845
Phone (308) 865-2263

Interoperability endpoints

  • Direct secure messaging: mhyde53428@hisp.bryanhealth.org

Organizations & group practices 3

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 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": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1932195161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3016 W. FAIDLEY AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "68803",
            "telephone_number": "308-381-8546",
            "fax_number": "308-381-8550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 22ND AVE STE 100",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688452226",
            "telephone_number": "308-865-2263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYDE",
        "first_name": "MIA",
        "middle_name": "J.",
        "name_prefix": "Mrs.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-22",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearney, NE

Sources for this page

Verify at the official NPI Registry.