Individual provider Active NPI

Matthew S. Bott, MD

  • Family Medicine Physician
  • Omaha, NE
National Provider Identifier
1982613790
Registry record updated May 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
22907 Issued in NE
Practice address
11810 Nicholas St Ste 101
Omaha, NE 68154-4414
Phone
(402) 779-8400
Fax
(402) 779-8401
NPI assigned
Aug 8, 2006
Last updated
May 22, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 22907 NE Primary

Addresses

Primary practice location

11810 Nicholas St Ste 101
Omaha, NE 68154-4414

Mailing address

11810 Nicholas St Ste 101
Omaha, NE 68154-4414
Phone (402) 779-8400

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
I20040824000906 NE Practitioner - Family Practice 1557335643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Nebraska College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11810 Nicholas St
Suite 101
Omaha, NE 68154-4453
Phone (402) 779-8400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22907NEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bessmer PC PastSince Feb 1, 2010 Accepting new patients
Alegent Health Immanuel Medical Center Past Accepting new patients
Alegent Creighton Clinic Family Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mbott8554@achce.catholichealth.net

Organizations & group practices 4

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 5

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558483200000",
    "number": "1982613790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11810 NICHOLAS ST STE 101",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681544414",
            "telephone_number": "402-779-8400",
            "fax_number": "402-779-8401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11810 NICHOLAS ST STE 101",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681544414",
            "telephone_number": "402-779-8400",
            "fax_number": "402-779-8401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTT",
        "first_name": "MATTHEW",
        "middle_name": "S.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2019-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "22907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.