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SOPHIA JOSEPHINE KETCHMARK PHYSICIAN ASSISTANT
NPI 1508582446
Physician Assistant in Omaha, NE

Active since October 12, 2022PECOS EnrolledAccepts Medicare Assignment
EMILE AND 42ND STREET, OMAHA, NE 68198(402) 559-4000 Get Directions Write a Review

NPPES record last updated: February 1, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 1, 2023, Oct 12, 2022 (2 updates tracked since 2022).

About Sophia Josephine Ketchmark Physician Assistant NPPES

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

SOPHIA JOSEPHINE KETCHMARK PHYSICIAN ASSISTANT (NPI 1508582446) is an individual physician assistant in Omaha, Nebraska, licensed in Nebraska (2878) and active in the NPI registry since October 2022. She is enrolled in Medicare PECOS, is affiliated with The Nebraska Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1508582446
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameSOPHIA JOSEPHINE KETCHMARKCredential: PHYSICIAN ASSISTANT
Location AddressEMILE AND 42ND STREETOmaha, NE 68198-4440
Mailing Address988102 Nebraska Medical CtrOmaha, NE 68198-8102
Phone(402) 559-4000
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateOctober 12, 2022
Last NPPES UpdateFebruary 1, 20232 updates tracked since enumeration
NPPES CertifiedJanuary 13, 2023
✔ NPI 1508582446 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in NE · 2878
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
EMILE AND 42ND STREET, Omaha, NE 68198
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Secondary Practice Locations 2

Location 11015 N 16th St Apt 217Omaha, NE 68102-4440 · Phone (402) 926-6229
Location 24350 Dewey AveOmaha, NE 68105-1017 · Phone (402) 552-2000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter from Sunflower Health Plan, Ambetter Health and more.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

Sophia Josephine Ketchmark Physician Assistant 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 ID2062885361
PECOS Enrollment IDI20230308000325
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.

Areas of Expertise CMS Part B claims

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.

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.
36 services36 patients

Hospital Affiliations CMS Care Compare 2

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

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

Bellevue Medical Center, LLC

Acute Care Hospitals · Bellevue, NE
5/5 CMS rating
OwnershipProprietary
CMS Certification Number280132
Location2500 Bellevue Medical Center DrBellevue, NE 68123 · Sarpy County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 68198 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
$66.00 typical visit price
range $16.90 – $131.25
Typical copayment $16.50 (range $4.22 – $32.81)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Sophia Ketchmark's NPI number?

The NPI number for Sophia Ketchmark is 1508582446. It was assigned to this individual provider in the NPPES registry on October 12, 2022.

Where is Sophia Ketchmark located?

Sophia Ketchmark practices at Emile And 42nd Street, Omaha, NE 68198. The listed phone number is (402) 559-4000.

What is Sophia Ketchmark's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Sophia Ketchmark enrolled in Medicare?

Yes. Sophia Ketchmark 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 Sophia Ketchmark 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 Sophia Ketchmark 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 Sophia Ketchmark affiliated with any hospitals?

According to CMS data, Sophia Ketchmark is affiliated with The Nebraska Medical Center and Bellevue Medical Center, LLC.

When was this NPI record last updated?

The NPPES record for Sophia Ketchmark was last updated on February 1, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.