Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Mary Louise Jorgenson, PA-C

Individual provider Physician Assistant · NPI 1073031233

Mrs. Mary Louise Jorgenson, PA-C is a Physician Assistant in Omaha, Nebraska. Qualified in 2017, 9 years ago. Practices with Avera McKennan, a 962-clinician group and accepts Medicare assignment. Licensed in Nebraska and South Dakota.

Years since qualifying
9
Licensed in
NE, SD
In the registry since
2017
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

4014 Leavenworth St
Omaha, NE 68105-1053
Phone: (402) 559-8000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 2370 (NE)
Physician Assistant Taxonomy 363A00000X · Licence 1107 (SD)

Record details

NPI number1073031233
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 7, 2017
Last updated in NPPESJuly 5, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Avera McKennan — 962 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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