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OMAHA NEPHROLOGY PC
NPI 1053407064
Internal Medicine - Nephrology in Omaha, NE

Active since October 05, 2006
1111 N 102ND CT STE 200, OMAHA, NE 68114(402) 502-2747(402) 502-2387 Get Directions Write a Review

NPPES record last updated: April 10, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 10, 2019, Aug 21, 2018, May 8, 2018 (3 updates tracked since 2018).

About Omaha Nephrology Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OMAHA NEPHROLOGY PC (NPI 1053407064) is a healthcare organization registered as a nephrology in Omaha, Nebraska and active in the NPI registry since October 2006. The organization lists David C Goldner, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1053407064
Entity TypeOrganization
Primary Taxonomy207RN0300X
Legal Business NameOMAHA NEPHROLOGY PC
Location Address1111 N 102ND CT STE 200Omaha, NE 68114-2194
Mailing Address1111 N 102nd Ct Ste 200Omaha, NE 68114-2194 · (402) 502-2747 · Fax (402) 502-2387
Phone(402) 502-2747
Fax(402) 502-2387
Organization SubpartNo
Authorized OfficialDavid C GoldnerAuthorized Official · (402) 502-2747
Enumeration DateOctober 5, 2006
Last NPPES UpdateApril 10, 20193 updates tracked since enumeration
✔ NPI 1053407064 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
1111 N 102ND CT STE 200, Omaha, NE 68114
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Other Identifiers 2

OtherCD3083NE · Railroad Medicare
Medicaid0993865IA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Sunflower Health Plan, Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Omaha Nephrology Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

11

Medicare enrollment records show 11 clinicians reassign Medicare billing to Omaha Nephrology PC, which bills Medicare for the services they deliver. Of these, 11 practice at this address. They are listed nearest first.

Clinicians by Medicare Specialty 3

Nephrology7
Nurse Practitioner3
Internal Medicine1

Clinicians, nearest first (11)

Christy Baker, APRN-NP
Nurse Practitioner
NPI 1457065716
1111 N 102ND CT STE 200
Omaha, NE 68114
(402) 502-2747
✔ PECOSSame address
Joseph Bast, M.D.
Nephrology
NPI 1124287131
1111 N 102ND CT STE 200
Omaha, NE 68114
(402) 502-2747
✔ PECOS✔ Accepts MedicareSame address
Judd Bauer, M.D.
Nephrology
NPI 1982833554
1111 N 102ND CT STE 200
Omaha, NE 68114
(402) 502-2747
✔ PECOS✔ Accepts MedicareSame address
Sonali Deshmukh, MD
Nephrology
NPI 1831126259
1111 N 102ND CT STE 200
Omaha, NE 68114
(402) 502-2747
✔ PECOS✔ Accepts MedicareSame address
Grant Fabry, APRN-NP
Nurse Practitioner
NPI 1306527148
1111 N 102ND CT STE 200
Omaha, NE 68114
(402) 502-2747
✔ PECOS✔ Accepts MedicareSame address
Sunil Jagadesh, MD
Internal Medicine
NPI 1932320066
1111 N 102ND CT STE 200
Omaha, NE 68114
(402) 502-2747
✔ PECOS✔ Accepts MedicareSame address
Heather Lechnowsky, MD
Nephrology
NPI 1568562064
1111 N 102ND CT STE 200
Omaha, NE 68114
(402) 502-2747
✔ PECOS✔ Accepts MedicareSame address
Richard Lund, M.D.
Nephrology
NPI 1609969468
1111 N 102ND CT STE 200
Omaha, NE 68114
(402) 502-2747
✔ PECOS✔ Accepts MedicareSame address
Audai Ma'ayah, MD
Nephrology
NPI 1538663315
1111 N 102ND CT STE 200
Omaha, NE 68114
(402) 502-2747
✔ PECOS✔ Accepts MedicareSame address
Eric Magliulo, MD
Nephrology
NPI 1336701689
1111 N 102ND CT STE 200
Omaha, NE 68114
(024) 502-2747
✔ PECOS✔ Accepts MedicareSame address
Julia Wageman, APRN
Nurse Practitioner
NPI 1326145129
1111 N 102ND CT STE 200
Omaha, NE 68114
(402) 502-2747
✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Omaha Nephrology PC's NPI number?

The NPI number for Omaha Nephrology PC is 1053407064. It was assigned to this organization in the NPPES registry on October 5, 2006.

Where is Omaha Nephrology PC located?

Omaha Nephrology PC is located at 1111 N 102nd Ct Ste 200, Omaha, NE 68114. The listed phone number is (402) 502-2747.

What is Omaha Nephrology PC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Omaha Nephrology PC enrolled in Medicare?

Yes. Omaha Nephrology PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Omaha Nephrology PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 11 clinicians in 3 Medicare specialties reassign their Medicare billing to Omaha Nephrology PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nephrology (7), Nurse Practitioner (3) and Internal Medicine (1). Of these, 11 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Omaha Nephrology PC accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Sunflower Health Plan list Omaha Nephrology PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Omaha Nephrology PC was last updated on April 10, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.