Mark D Andersen, M.D.
Individual provider Active NPI Family Medicine Physician · Omaha, NE
NPI 1972525251 · NPPES record last updated Jan 8, 2015
Key facts
- NPI
- 1972525251
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 18719 (NE)
- Practice address
- 16101 Evans St
Omaha, NE 68116-2020 - Phone
- (402) 717-9700
- Fax
- (402) 717-9701
- NPI assigned
- Jul 24, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Sanford School of Medicine of University of South Dakota, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Alegent Creighton Clinic
Select Rehabilitation, LLC
Practice addresses (Care Compare)
16101 Evans St
Omaha, NE 68116-6447
Phone (402) 717-9700
2600 Compass Rd
Glenview, IL 60026-8001
Hospital & facility affiliations
- Physicians Choice Home Health Care
- CHI Health Bergan Mercy
- CHI Health Lakeside
- CHI Health Immanuel
- CHI Health Midlands
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NE
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090407000279 | NE | Practitioner - Family Practice | 8022165133 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alegent Creighton Clinic | Family Medicine | Current |
Accepting new patients |
| Midwest Family Physicians. PC | Family Medicine | Past | Accepting new patients |
| Alegent Creighton Clinic | Family Medicine | Past | Accepting new patients |
| Alegent Creighton Clinic | Family Medicine | Past | Accepting new patients |
Locations
2771 Solution Ctr
Chicago, IL 60677
4220 L St
#100
Omaha, NE 68107
Phone (402) 733-4433
7261 Mercy Rd
Omaha, NE 68124
Phone (402) 398-6248
7710 Mercy Rd
Ste 426
Omaha, NE 68124
Phone (402) 343-8650
16909 Lakeside Hills Ct
Ste 401
Omaha, NE 68130
Phone (402) 827-4920
16101 Evans St
Omaha, NE 68116
Phone (402) 717-9700
Interoperability endpoints
- mandersen8461@achce.catholichealth.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 18719 | NE | Yes |
Addresses
Primary practice location
16101 Evans St
Omaha, NE 68116-2020
Mailing address
PO Box 642117
Omaha, NE 68164-8117
Phone (402) 398-6254
Other providers in Omaha, NE
- Katie E Andersen
- Kellen Michael Andersen
- Lindy Andersen
- Luke Donald Andersen
- Mark A Andersen
- Rachel Anne Andersen
- Robert Chris Andersen
- Robert Vernon Andersen
- Robyn Sue Andersen
- Theresa Andersen
All providers in Omaha, NE · Family Medicine Physician in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.