MR. MATTHEW PAUL VAN TINE (NPI# 1447468590) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447468590 |
| Entity Type | Individual |
| Full Name | MR. MATTHEW PAUL VAN TINE |
| Credential | PA-C |
| Practice Address |
4239 Farnam St Ste 100 Omaha NE 68131-2858 |
| Practice Telephone | 4025522320 |
| Practice Fax Number | 4025522330 |
| Mailing Telephone | 4025522320 |
| Mailing Fax Number | 4025522330 |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2009-05-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 1437 | NE | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | C0003493 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4239 FARNAM ST STE 100 |
| City | OMAHA |
| State | NE |
| Zip Code | 68131-2858 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861503427 | Antonio P Reyes | Internal Medicine | 4239 Farnam St Ste 100, Omaha, NE 68131-2858 | 2006-08-31 |
| 1518505205 | Callista Lee Komasincki | Nurse Practitioner | 4239 Farnam St Ste 100, Omaha, NE 68131-2858 | 2019-12-13 |
| 1184094179 | Kyana R Holder | Nurse Practitioner | 4239 Farnam St Ste 100, Omaha, NE 68131-2858 | 2015-10-02 |
| 1144577891 | Kiley J Meyer | Nurse Practitioner | 4239 Farnam St Ste 100, Omaha, NE 68131-2858 | 2012-08-13 |
| 1528355138 | Jitendra B. Pandya | Internal Medicine | 4239 Farnam St Ste 100, Omaha, NE 68131-2858 | 2011-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821626086 | Spring Forward Ot, LLC | Occupational Therapist | 429 N. 38th Ave, Omaha, NE 68131 | 2020-03-31 |
| 1568944528 | Amy Vodicka | Case Manager/Care Coordinator | 3612 Cuming St., Omaha, NE 68131 | 2018-09-05 |
| 1982121919 | Lakeisha Marie Phelps | Peer Specialist | 3568 Dodge St, Omaha, NE 68131 | 2017-08-30 |
| 1063939098 | William L. Rolfe | Community Health Worker | 3568 Dodge Street, Suite 2, Omaha, NE 68131 | 2017-08-30 |
| 1578086294 | Nebraska Family Support Network | Community/Behavioral Health | 3568 Dodge St Ste 2, Omaha, NE 68131 | 2017-07-25 |
| 1124558937 | Beverly Hamilton | Case Manager/Care Coordinator | 3612 Cuming, Omaha, NE 68131 | 2017-06-14 |
| 1396291068 | Elizabeth George | Internal Medicine | 601 N. 30th St. Cu Department of Internal Medicine, Omaha, NE 68131 | 2016-08-31 |
| 1639625999 | Samuel Ramon Brown | Surgery | 601 N. 30th St. Cu Department of Surgery, Omaha, NE 68131 | 2016-08-28 |
| 1205289238 | Srilakshmi Reddy | Surgery | 601 N 30th St -cu Department of General Surgery, Omaha, NE 68131 | 2016-07-14 |
| 1881069409 | Jordan Sieh | Behavioral Analyst | 444 S. 44th St, Omaha, NE 68131 | 2015-12-08 |
| Find all providers in zip 68131 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475375 | Patrick Donald Heavey | Physician Assistant | 4660 Pine St, Omaha, NE 68106-2520 | 2020-10-22 |
| 1780297440 | Tayler Marie Llewellyn | Physician Assistant | 17241 Oak Dr, Omaha, NE 68130-2428 | 2020-08-24 |
| 1154933992 | Alexandria Rae Mctaggart | Physician Assistant | 5024 S 130th St, Omaha, NE 68137-1820 | 2020-08-22 |
| 1124651443 | Kathryn A Kesti | Physician Assistant | 4242 Farnam St Ste 500, Omaha, NE 68131-2850 | 2020-02-14 |
| 1760014757 | Timothy Shew | Physician Assistant | 7500 Mercy Rd Ste 1300, Omaha, NE 68124-2319 | 2020-02-07 |
| 1083264303 | Alicia K Clough | Physician Assistant | 15236 Westchester Dr, Omaha, NE 68154-2060 | 2019-09-18 |
| 1669935565 | Taylor Elizabeth Hepp | Physician Assistant | 8005 Farnam Dr Ste 204, Omaha, NE 68114-3426 | 2019-04-09 |
| 1851895924 | Mohammed Saeb Shakir | Physician Assistant | 7306 Ontario St, Omaha, NE 68124-3561 | 2018-03-22 |
| 1386162790 | Anna Jean Sorrell | Physician Assistant | Emile St & S 42nd St, Omaha, NE 68198-4742 | 2017-09-06 |
| 1659804292 | Kaitlyn Ann Boosalis | Physician Assistant | 4331 Mayberry St, Omaha, NE 68105-1711 | 2017-04-11 |
| 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.