Individual provider Active NPI

Zachary Roth, DNAP

  • Certified Registered Nurse Anesthetist
  • Omaha, NE
National Provider Identifier
1992398705
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
101647 Issued in NE
Practice address
2808 S 143Rd PLZ
Omaha, NE 68144-5611
Phone
(402) 609-3000
NPI assigned
Feb 12, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 82464 NE
Certified Registered Nurse Anesthetist 367500000X 101647 NE Primary

Addresses

Primary practice location

2808 S 143Rd PLZ
Omaha, NE 68144-5611

Mailing address

1310 Santa Fe Cir
Papillion, NE 68046-3846
Phone (402) 926-9706

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210602000726 NE Practitioner - Certified Registered Nurse Anesthetist (Crna) 3072912641 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Medical Imaging LLCGroup PAC ID 0840265773, 38 clinicians

Practice addresses (Care Compare)

7555 Pioneers Blvd
Lincoln, NE 68506-4673
Phone (402) 484-6677

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
82464NEMDRegistered Nurse
101647NEMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Medical Imaging, LLC CurrentSince Jul 20, 2024 Accepting new patients
Hinners Geriatric Medicine, LLC PastSince Feb 1, 2022 Accepting new patients

Locations

7601 Pioneers Blvd
Lincoln, NE 68506
Phone (402) 484-4475

7555 Pioneers Blvd
Lincoln, NE 68506
Phone (402) 261-1085

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1613088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1992398705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 SANTA FE CIR",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680463846",
            "telephone_number": "402-926-9706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2808 S 143RD PLZ",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681445611",
            "telephone_number": "402-609-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "ZACHARY",
        "credential": "DNAP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-12",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NE",
            "license": "82464",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NE",
            "license": "101647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.