STEFANIE L BOLTE (NPI# 1104877018) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104877018 |
| Entity Type | Individual |
| Full Name | STEFANIE L BOLTE |
| Practice Address |
10707 Pacific St Suite 101 Omaha NE 68114-4762 |
| Mailing Address |
Po Box 8577 Omaha NE 68108-0577 |
| Practice Telephone | 4023977989 |
| Practice Fax Number | 4023937554 |
| Mailing Telephone | 4023977989 |
| Mailing Fax Number | 4023978703 |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2013-03-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208800000X | Urology | 36776 | IA | Allopathic & Osteopathic Physicians |
| Y | 208800000X | Urology | 23778 | NE | Allopathic & Osteopathic Physicians |
| N | 208800000X | Urology | 44887 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | MEDICARE | 098396 | 01 |
| Street Address |
10707 PACIFIC ST SUITE 101 |
| City | OMAHA |
| State | NE |
| Zip Code | 68114-4762 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609879733 | Euclid J. De Souza | Urology | 10707 Pacific St, Suite 101, Omaha, NE 68114-4762 | 2005-05-23 |
| 1821517087 | Amy Elizabeth Bullington | Nurse Practitioner | 10707 Pacific St, Omaha, NE 68114-4762 | 2017-09-19 |
| 1346794559 | Rachelle Tappe | Nurse Practitioner | 10707 Pacific St, Suite 101, Omaha, NE 68114-4762 | 2016-08-05 |
| 1386089332 | Marnie Elizbeth Jean Dellutri | Physician Assistant | 10707 Pacific St, Suite 101, Omaha, NE 68114-4762 | 2013-05-03 |
| 1497095525 | Meghann M Reller | Nurse Practitioner | 10707 Pacific St, Suite 102, Omaha, NE 68114-4762 | 2013-02-27 |
| 1245535939 | Michaela Marie Duggan | Physician Assistant | 10707 Pacific St, Suite 101, Omaha, NE 68114-4762 | 2011-01-11 |
| 1629372677 | April Hansen | Physician Assistant | 10707 Pacific St, Suite 101, Omaha, NE 68114-4762 | 2011-01-05 |
| 1467604306 | Julie Diane Wilson | Nurse Practitioner | 10707 Pacific St, Suite 101, Omaha, NE 68114 | 2008-10-22 |
| 1932360914 | Joshua Priluck | Ophthalmology | 10707 Pacific St, Suite 121, Omaha, NE 68114-4762 | 2008-06-22 |
| 1235326877 | Donalee Kennedy | Nurse Practitioner | 10707 Pacific St, Suite 101, Omaha, NE 68114-4762 | 2007-09-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689237356 | Jared Nathan Holthaus | Optometrist | 625 N. 98th St, Omaha, NE 68114 | 2019-04-18 |
| 1346701869 | On Site Health and Wellness, LLC | Dietitian, Registered | 7905 Pacific Street, Omaha, NE 68114 | 2019-03-27 |
| 1801301205 | Logan Johnson | Specialist/Technologist | 8803 Webster Plz, Omaha, NE 68114 | 2017-12-06 |
| 1992224687 | Douglas Medical Supplies | Durable Medical Equipment & Medical Supplies | 7914 W Dodge Rd Ste 916, Omaha, NE 68114 | 2017-09-13 |
| 1023568540 | Active Spine Physical Therapy, LLC | Clinic/Center | 10110 Nicholas St Ste 100, Omaha, NE 68114 | 2016-10-07 |
| 1417400706 | Kayla Ann Leddy | Counselor | 7701 Pacific St Ste 100a, Omaha, NE 68114 | 2016-08-03 |
| 1134561103 | Julio Cesar Deleon Iv | Counselor | 9212 California Plaza #308, Omaha, NE 68114 | 2013-07-19 |
| 1477992261 | Nicole Janine Lecci | Dentist | 8910 Indian Hills Drive, Suite 200, Omaha, NE 68114 | 2013-06-14 |
| 1538504436 | Christian Louis Barney | Radiology | 8303 Dodge St Ste Ll6, Omaha, NE 68114 | 2013-05-06 |
| 1558606665 | Nbd Solutions | Durable Medical Equipment & Medical Supplies | 327 N 78 Street, Omaha, NE 68114 | 2012-11-29 |
| Find all providers in zip 68114 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033524640 | Jennifer Dwyer | Urology | 984110 Nebraska Medical Ctr, Omaha, NE 68198-4110 | 2014-06-23 |
| 1326301995 | Harry Jeoffrey Deeths | Urology | 402 N 97th Ct, Omaha, NE 68114-2395 | 2012-06-19 |
| 1780944652 | Hanhan Li | Urology | 4101 Woolworth Ave Ste 112, Omaha, NE 68105-1850 | 2012-05-24 |
| 1477555753 | Gernon A Longo | Urology | 7710 Mercy Rd, Ste 608, Omaha, NE 68124-2346 | 2005-06-01 |
| 1174526198 | Jon J Morton | Urology | 111 S 90th St, Omaha, NE 68114-3907 | 2005-05-23 |
| 1609879733 | Euclid J. De Souza | Urology | 10707 Pacific St, Suite 101, Omaha, NE 68114-4762 | 2005-05-23 |
| 1467076216 | Cole Bowdino | Urology | 984110 Nebraska Medical Ctr, Omaha, NE 68198-4110 | 2020-06-07 |
| 1720630775 | Houda Abdelrahman | Urology | 7710 Mercy Road, Suite 202, Cu Department of Urology, Omaha, NE 68124-2353 | 2019-07-10 |
| 1285293761 | Jordan Andrew Stegman | Urology | 984110 Nebraska Medical Ctr, Omaha, NE 68198-4110 | 2019-06-10 |
| 1881259489 | Andrew John Blazek | Urology | 984110 Nebraska Medical Ctr, Omaha, NE 68198-4110 | 2019-05-08 |
| Find all providers in OMAHA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.