| Scott J. Fasse, M.d., P.c. | |
|
614 N 108th Ct Omaha NE 68154-1762 | |
| (402) 884-7218 | |
| (402) 884-7589 |
| Full Name | Scott J. Fasse, M.d., P.c. |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 614 N 108th Ct, Omaha, Nebraska |
| Authorized Official Name and Position | Scott J. Fasse (PRESIDENT) |
| Authorized Official Contact | 4028847218 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Scott J. Fasse, M.d., P.c. 614 N 108th Ct Omaha NE 68154-1762 Ph: (402) 884-7218 | Scott J. Fasse, M.d., P.c. 614 N 108th Ct Omaha NE 68154-1762 Ph: (402) 884-7218 |
| NPI Number | 1679657423 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 5991791063 |
|---|---|
| Medicare Enrollment ID | O20040423000153 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679657423 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
| Provider Name | Scott J Fasse |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154405090 PECOS PAC ID: 1254323439 Enrollment ID: I20040330001121 |
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