VICKI LEE BANGERT PA
NPI 1225173859
Physician Assistant - Medical in Omaha, NE

Active since February 21, 2007PECOS EnrolledAccepts Medicare Assignment
4920 S 30TH ST, SUITE 103, OMAHA, NE 68107(402) 734-4110(402) 991-5642 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Vicki Lee Bangert Pa NPPES

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

VICKI LEE BANGERT PA (NPI 1225173859) is an individual medical provider in Omaha, Nebraska, licensed in Nebraska (1291) and active in the NPI registry since February 2007. She is enrolled in Medicare PECOS and is a graduate of Other (2006).

NPPES Registry Identity

NPI1225173859
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameVICKI LEE BANGERTCredential: PA
Location Address4920 S 30TH ST, SUITE 103Omaha, NE 68107-1590
Mailing Address4920 S 30th St, Suite 103Omaha, NE 68107 · (402) 734-4110 · Fax (402) 991-5642
Fax(402) 991-5642
Sole ProprietorNo
Medical School CMSOtherGraduated 2006
Enumeration DateFebruary 21, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1225173859 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in NE · 1291
4920 S 30TH ST, Omaha, NE 68107

Other Names 1

Former Name (1)Vicki Lee Pethoud Pa

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Vicki Lee Bangert Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4789757188
PECOS Enrollment IDI20080717000731
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Mental Health)
4920 S 30TH ST, SUITE 103
OMAHA, NE 68107
Pharmacist
4920 S 30TH ST, SUITE 103
OMAHA, NE 68107
Family Medicine
4920 S 30TH ST, SUITE 103
OMAHA, NE 68107
Dental Hygienist
4920 S 30TH ST
OMAHA, NE 68107
Nurse Practitioner (Family)
4920 S 30TH ST, SUITE 103
OMAHA, NE 68107
Technician (Personal Care Attendant)
4920 S 30TH ST
OMAHA, NE 68107
Nurse Practitioner (Family)
4920 S 30TH ST
OMAHA, NE 68107
Family Medicine
4920 S 30TH ST, SUITE 103
OMAHA, NE 68107

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 Vicki Bangert's NPI number?

The NPI number for Vicki Bangert is 1225173859. It was assigned to this individual provider in the NPPES registry on February 21, 2007. The provider is also known as Vicki Lee Pethoud PA.

Where is Vicki Bangert located?

Vicki Bangert practices at 4920 S 30th St Suite 103, Omaha, NE 68107. The listed phone number is (402) 734-4110.

What is Vicki Bangert's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Vicki Bangert enrolled in Medicare?

Yes. Vicki Bangert is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Vicki Bangert accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and Blue Cross and Blue Shield of Nebraska and 3 other insurers list Vicki Bangert 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 Vicki Bangert was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.