Individual provider Active NPI

Tracey E Kolund, PA-C

  • Physician Assistant
  • Omaha, NE
National Provider Identifier
1992024400
Registry record updated Dec 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
002099 Issued in IA
Practice address
8303 Dodge St
Suite 300
Omaha, NE 68114-4108
Phone
(403) 354-5250
Fax
(402) 354-3437
NPI assigned
May 24, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2013

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 002099 IA Primary

Addresses

Primary practice location

8303 Dodge St
Suite 300
Omaha, NE 68114-4108

Mailing address

PO Box 10190
Virginia Beach, VA 23450-0190
Phone (800) 477-5240

Other identifiers 1

IdentifierTypeStateIssuer
10025044500MedicaidNE

Other names 1

  • Tracey E Hyda Other name

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
I20130131000066 NE Practitioner - Physician Assistant 7517098965 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nebraska Methodist HospitalGroup PAC ID 6901707447, 132 clinicians

Practice addresses (Care Compare)

707 N 190TH Plaza
Elkhorn, NE 68022-3974
Phone (402) 815-4000

717 N 190TH Plaza
Suite 2400
Elkhorn, NE 68022-3974
Phone (402) 815-1901

8303 Dodge St
Omaha, NE 68114-4108

8303 W Dodge St
Omaha, NE 68114-4108
Phone (402) 354-9400

Hospital & facility affiliations

  • The Nebraska Methodist Hospital Hospital, Omaha, NE, CCN 280040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1503NEMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Nebraska Methodist Hospital Current Accepting new patients
Nebraska Methodist Hospital Physician Assistant CurrentSince Jan 14, 2013 Accepting new patients
Medifast Urgent Care LLC Current Accepting new patients

Locations

3830 N 167th Ct
Omaha, NE 68116
Phone (402) 502-2290

8303 Dodge St
Ste 300
Omaha, NE 68114
Phone (402) 354-5250

Interoperability endpoints

  • Direct secure messaging: tracey.kolund@direct.nmhs.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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1274659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386892800000",
    "number": "1992024400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10190",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234500190",
            "telephone_number": "800-477-5240",
            "fax_number": "757-463-6572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8303 DODGE ST",
            "address_2": "SUITE 300",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144108",
            "telephone_number": "403-354-5250",
            "fax_number": "402-354-3437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLUND",
        "first_name": "TRACEY",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-24",
        "last_updated": "2013-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "002099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025044500",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACEY",
            "last_name": "HYDA",
            "middle_name": "E",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.