HENRY JOHN DETHLEFS MD
NPI 1255364568
Family Medicine in Omaha, NE

Active since July 09, 2006PECOS EnrolledAccepts Medicare Assignment
4920 S 30TH ST, SUITE 103, OMAHA, NE 68107(402) 734-4110(402) 991-5564 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Henry John Dethlefs Md NPPES

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

HENRY JOHN DETHLEFS MD (NPI 1255364568) is an individual family medicine provider in Omaha, Nebraska, licensed in Nebraska (19813) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and is a graduate of University Of Nebraska College Of Medicine (1992).

NPPES Registry Identity

NPI1255364568
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameHENRY JOHN DETHLEFSCredential: MD
Location Address4920 S 30TH ST, SUITE 103Omaha, NE 68107-1590
Mailing Address4920 S 30th St, Suite 103Omaha, NE 68107-1590 · (402) 734-4110 · Fax (402) 991-5564
Fax(402) 991-5564
Sole ProprietorNo
Medical School CMSUniversity Of Nebraska College Of MedicineGraduated 1992
Enumeration DateJuly 9, 2006
Last NPPES UpdateJuly 8, 2007
NPI 1255364568 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in NE · 19813
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
4920 S 30TH ST, Omaha, NE 68107

Other Identifiers 1

Medicare UPING16698NE

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

Henry John Dethlefs Md 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 ID840363248
PECOS Enrollment IDI20080717000683
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 68107 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.20 typical visit price
range $52.69 – $160.21
Typical copayment $20.30 (range $13.17 – $40.05)
Most-billed visit code 99203
Established Patient
$93.55 typical visit price
range $16.90 – $131.25
Typical copayment $23.38 (range $4.22 – $32.81)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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
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
Counselor (Mental Health)
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 Henry Dethlefs's NPI number?

The NPI number for Henry Dethlefs is 1255364568. It was assigned to this individual provider in the NPPES registry on July 9, 2006.

Where is Henry Dethlefs located?

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

What is Henry Dethlefs's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Henry Dethlefs enrolled in Medicare?

Yes. Henry Dethlefs 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 Henry Dethlefs 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 Henry Dethlefs 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 Henry Dethlefs 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.