Individual provider Active NPI

Samuel Dominic Troia II, OTD OTR/L

  • Pediatric Occupational Therapist
  • Omaha, NE
National Provider Identifier
1023842002
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
Practice address
12100 W Center Rd Ste 518
Omaha, NE 68144-3960
Phone
(402) 933-2882
NPI assigned
Aug 30, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 2603 NE
Pediatric Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0200X NE Primary

Addresses

Primary practice location

12100 W Center Rd Ste 518
Omaha, NE 68144-3960

Mailing address

26615 Blondo CT
Waterloo, NE 68069-6215
Phone (402) 699-0095

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2603NEMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1724976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1023842002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26615 BLONDO CT",
            "city": "WATERLOO",
            "state": "NE",
            "postal_code": "680696215",
            "telephone_number": "402-699-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12100 W CENTER RD STE 518",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681443960",
            "telephone_number": "402-933-2882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROIA",
        "first_name": "SAMUEL",
        "middle_name": "DOMINIC",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "OTD OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-30",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NE",
            "license": "2603",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NE",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.