BREA SMITH PROFFITT (PAC) – Medical Physician Assistant, NPI 1114481546

BREA SMITH PROFFITT (PAC) is a healthcare provider. based in Nebraska city, Nebraska. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PAC. They hold a License No. 2318 (NE). The NPI Number for BREA SMITH PROFFITT (PAC) is 1114481546

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
BREA SMITH PROFFITT (PAC)
NPI
1114481546
Phone
(402) 873-4242
Address
1301 GRUNDMAN BLVD STE A
Enumeration Date
30 January 2019
Last Update Date
30 January 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4028734242
Graduation Year
2018 (8 years ago)
PAC ID
7911245048
Group Practice PAC ID
7113831926
Professional Enrollment ID
I20190214001228
Address ID
NE684103320NE1301XBLVD301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:7State licenses:1Digital endpointsOther names

1,396 PHYSICIAN ASSISTANT in NE

Provider Addresses for BREA SMITH PROFFITT (PAC)

  • 1301 GRUNDMAN BLVD STE A

    NEBRASKA CITY, NE 684103320

    Phone: (402) 873-4242

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 24 Open Payments records for all available years, with a total value of $412.

Total Amount is formed as General ($412) + Research ($0) + Ownership ($0) = $412.

Last reported payment date: 2024-12-20 • Largest payer in this snapshot: ABBVIE INC. ($227).

Total Amount

$412

General + Research + Ownership

Payments

24

Total payment records

General Amount

$412

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-20

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-02-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190214001228IPhysician AssistantNETBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 68410)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7113831926View full group profile
NameSpecialtyState
Family PracticeNE
Physician AssistantNE
Family PracticeNE
Family PracticeNE
Physician AssistantNE
Physician AssistantNE
Certified Registered Nurse Anesthetist (Crna)NE
Hospitalist, Internal MedicineNE
Family PracticeNE
Nurse PractitionerNE

Reviews

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Frequently asked questions

How do I look up BREA SMITH PROFFITT (PAC) by NPI?
Use NPI 1114481546 when you need to reference BREA SMITH PROFFITT (PAC) in forms, claims, or directories.
Is BREA SMITH PROFFITT (PAC) active in the national directory?
BREA SMITH PROFFITT (PAC)'s public NPI profile is in an active state.
Can you summarize BREA SMITH PROFFITT (PAC)'s specialty in plain language?
Clinically, the directory lists BREA SMITH PROFFITT (PAC) with Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
Where does public data place BREA SMITH PROFFITT (PAC)?
The snapshot lists Nebraska City, Nebraska for BREA SMITH PROFFITT (PAC); download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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