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JULIE A THEIS M.D.
NPI 1295712842
Family Medicine in Superior, NE

Active since December 26, 2005PECOS EnrolledAccepts Medicare Assignment
94.57/100
CMS Quality Rating
525 E 11TH ST, SUPERIOR, NE 68978(402) 879-4781(402) 879-3365 Get Directions Write a Review

NPPES record last updated: September 9, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Julie A Theis M.d. NPPES

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

JULIE A THEIS M.D. (NPI 1295712842) is an individual family medicine provider in Superior, Nebraska, licensed in Nebraska (21928) and active in the NPI registry since December 2005. She is enrolled in Medicare PECOS, is affiliated with Bryan Medical Center, and is a graduate of University Of Nebraska College Of Medicine (2000).

NPPES Registry Identity

NPI1295712842
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameJULIE A THEISCredential: M.D.
Location Address525 E 11TH STSuperior, NE 68978-1101
Mailing AddressPo Box 407Superior, NE 68978-0407 · (402) 879-4781 · Fax (402) 879-3365
Phone(402) 879-4781
Fax(402) 879-3365
Sole ProprietorNo
Medical School CMSUniversity Of Nebraska College Of MedicineGraduated 2000
Enumeration DateDecember 26, 2005
Last NPPES UpdateSeptember 9, 2020
NPPES CertifiedSeptember 9, 2020
✔ NPI 1295712842 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 · 21928
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.
525 E 11TH ST, Superior, NE 68978
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Other Identifiers 1

Medicaid47038801213NE

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 and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Julie A Theis M.d. 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 ID42247439
PECOS Enrollment IDI20050718000456
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.

Medicare Billing Reassignment

Medicare enrollment records show Julie Theis reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Brodstone Memorial Hospital
Same address
Rural Health
525 E 11TH ST
Superior, NE 68978
  • Reassigned Medicare billing, Nebraska enrollment
  • Also billed through NPI 1306842604 (Nebraska)
  • 22 clinicians in this Medicare group
NPI 1073590626 (402) 879-4781

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

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
53 services32 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
39 services34 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
21 services21 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
14 services14 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
13 services13 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Bryan Medical Center

Acute Care Hospitals · Lincoln, NE
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number280003
Location1600 South 48th StLincoln, NE 68506 · Lancaster County
Emergency services Birthing friendly

The Nebraska Medical Center

Acute Care Hospitals · Omaha, NE
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number280013
Location987400 Nebraska Medical CenterOmaha, NE 68198 · Douglas County
Emergency services Birthing friendly

Mary Lanning Healthcare

Acute Care Hospitals · Hastings, NE
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number280032
Location715 N St Joseph AveHastings, NE 68901 · Adams County
Emergency services Birthing friendly

Brodstone Healthcare

Critical Access Hospitals · Superior, NE
OwnershipProprietary
CMS Certification Number281315
LocationP O Box 187, 520 East 10th StSuperior, NE 68978 · Nuckolls County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 68978 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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

94.57/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality87.26
Promoting Interoperability94.37
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 22

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
4 suppliers46 claims94 services$5.47 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
2 suppliers29 claims29 services$1.02 avg. paid by Medicare
Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
4 suppliers19 claims19 services$46.21 avg. paid by Medicare
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003
DME-Other DME · category DE000N
1 supplier16 claims20 services$2.02 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
2 suppliers13 claims13 services$119.71 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
3 suppliers15 claims34 services$44.71 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 7

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

BRODSTONE MEMORIAL HOSPITAL
Clinic/Center (Rural Health)
525 E 11TH ST
SUPERIOR, NE 68978
Nuckolls County (402) 879-4781
MATTHEW GATLIN PA-C
Physician Assistant
525 E 11TH ST
SUPERIOR, NE 68978
Nuckolls County (402) 879-4781
TERESA B FRAHM NP
Nurse Practitioner
525 E 11TH ST
SUPERIOR, NE 68978
Nuckolls County (402) 879-4781
ALISHA FANGMEYER APRN
Nurse Practitioner (Family)
525 E 11TH ST
SUPERIOR, NE 68978
Nuckolls County (402) 879-4781
ROBERT G LEIBEL M.D.
Family Medicine
525 E 11TH ST
SUPERIOR, NE 68978
Nuckolls County (402) 879-4781
MR. TIMOTHY BLECHA MD
Family Medicine
525 E 11TH ST
SUPERIOR, NE 68978
Nuckolls County (402) 879-4781
JASON G HASS P.A.
Physician Assistant
525 E 11TH ST
SUPERIOR, NE 68978
Nuckolls County (402) 879-4781

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 Julie Theis's NPI number?

The NPI number for Julie Theis is 1295712842. It was assigned to this individual provider in the NPPES registry on December 26, 2005.

Where is Julie Theis located?

Julie Theis practices at 525 E 11th St, Superior, NE 68978. The listed phone number is (402) 879-4781.

What is Julie Theis's specialty?

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

Is Julie Theis enrolled in Medicare?

Yes. Julie Theis 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.

Which organization bills Medicare for Julie Theis's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Julie Theis reassigns Medicare benefits to Brodstone Memorial Hospital (Superior, NE). The 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 Julie Theis's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Julie Theis accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Sunflower Health Plan, Blue Cross and Blue Shield of Nebraska and Oscar Insurance Company and 1 other insurer list Julie Theis 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.

Is Julie Theis affiliated with any hospitals?

According to CMS data, Julie Theis is affiliated with Bryan Medical Center, The Nebraska Medical Center, Mary Lanning Healthcare and Brodstone Healthcare.

When was this NPI record last updated?

The NPPES record for Julie Theis was last updated on September 9, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.