CODY JACOB THORSON (PA-C) – Physician Assistant, NPI 1154951895

CODY JACOB THORSON (PA-C) is a healthcare provider. based in Omaha, Nebraska. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 2428 (NE). The NPI Number for CODY JACOB THORSON (PA-C) is 1154951895

Main info

Male
7 Years Of Experience
Accepts Medicare Assignment
Name
CODY JACOB THORSON (PA-C)
NPI
1154951895
Phone
(402) 734-4110
Address
4920 S 30TH ST STE 103
Enumeration Date
22 January 2020
Last Update Date
3 February 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4027344110
Graduation Year
2019 (7 years ago)
PAC ID
2264861954
Group Practice PAC ID
3173435153
Professional Enrollment ID
I20200331003695
Address ID
NE681071656OM4920XSTXX404
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:6State licenses:1Digital endpointsOther names

1,396 PHYSICIAN ASSISTANT in NE

Provider Addresses for CODY JACOB THORSON (PA-C)

  • 4920 S 30TH ST STE 103

    OMAHA, NE 681071656

    Phone: (402) 734-4110

    Fax: (402) 401-6005

    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 4 Open Payments records for all available years, with a total value of $495.

Total Amount is formed as General ($495) + Research ($0) + Ownership ($0) = $495.

Last reported payment date: 2024-02-06 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($242).

Total Amount

$495

General + Research + Ownership

Payments

4

Total payment records

General Amount

$495

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-02-06

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: 2020-03-31

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
I20200331003695IPhysician 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 68107)

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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: 3173435153View full group profile
NameSpecialtyState
-NE
Mental Health CounselorNE
Nurse PractitionerNE
Family PracticeNE
Family PracticeNE
Nurse PractitionerOR
Certified Nurse Midwife (Cnm)NE
Family PracticeNE
Family PracticeNE
Physician AssistantNE

Reviews

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Frequently asked questions

What identifier follows CODY JACOB THORSON (PA-C) across health systems?
The NPI 1154951895 uniquely identifies CODY JACOB THORSON (PA-C) in U.S. healthcare data.
Should I treat CODY JACOB THORSON (PA-C) as an active provider?
Patients and plans typically see CODY JACOB THORSON (PA-C) as active in the national extract.
What services align with CODY JACOB THORSON (PA-C)'s listing?
CODY JACOB THORSON (PA-C)'s public classification highlights Physician Assistant. Clinical services aligned with this taxonomy classification.
Can patients visit CODY JACOB THORSON (PA-C) in Omaha, Nebraska?
For routing, start with Omaha, Nebraska for CODY JACOB THORSON (PA-C), then verify phone and hours locally.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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