Active NPI
Peter Roy Straub, D.D.S.
- General Practice Dentistry
- Omaha, NE
National Provider Identifier
1003855602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 5841
- Practice address
- 15909 W Maple Rd
Suite 102
Omaha, NE 68116-2004 - Phone
- (402) 991-6965
- NPI assigned
- Jun 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5841 | NE | Primary |
Addresses
Primary practice location
15909 W Maple Rd
Suite 102
Omaha, NE 68116-2004
Mailing address
15909 W Maple Rd
Suite 102
Omaha, NE 68116-2004
Phone (402) 991-6965
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05489 | Other | NE | BCBS PROVIDER # |
| 969607 | Other | NE | UNITED CONCORDIA PROVIDER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190530002463 | NE | Order and Referring Only - Dentist | 3779816061 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5841 | NE | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1003855602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15909 W MAPLE RD",
"address_2": "SUITE 102",
"city": "OMAHA",
"state": "NE",
"postal_code": "681162004",
"telephone_number": "402-991-6965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15909 W MAPLE RD",
"address_2": "SUITE 102",
"city": "OMAHA",
"state": "NE",
"postal_code": "681162004",
"telephone_number": "402-991-6965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STRAUB",
"first_name": "PETER",
"middle_name": "ROY",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-06",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NE",
"license": "5841",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER #",
"identifier": "05489",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA PROVIDER",
"identifier": "969607",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.