Individual provider Active NPI

Jayanthi Ganesan, M.D.

  • Hospitalist Physician
  • Omaha, NE
National Provider Identifier
1033128251
Registry record updated Sep 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
22567 Issued in NE
Practice address
16901 Lakeside Hills CT
Attn: Hospital Medicine
Omaha, NE 68130-2318
Phone
(402) 398-6255
Fax
(402) 829-8513
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 22567 NE
Hospitalist Physician 208M00000X MD-37779 IA
Hospitalist Physician 208M00000X 22567 NE Primary

Addresses

Primary practice location

16901 Lakeside Hills CT
Attn: Hospital Medicine
Omaha, NE 68130-2318

Mailing address

7261 Mercy Rd
Omaha, NE 68124-2311
Phone (402) 398-6255

Other identifiers 1

IdentifierTypeStateIssuer
10025027500MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20031210000742 NE Practitioner - HospitalistPractitioner - Internal Medicine 1355255548 Reassigns benefits to 1 organization
I20131029001523 IA Practitioner - HospitalistPractitioner - Internal Medicine 1355255548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton ClinicGroup PAC ID 1951210418, shared by 2 NPIs, 951 clinicians

Practice addresses (Care Compare)

16901 Lakeside Hills CT
Omaha, NE 68130-2318
Phone (855) 524-4001

800 Mercy Dr
Council Bluffs, IA 51503-3128
Phone (712) 328-5490

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic Internal Medicine CurrentSince Jul 1, 2014 Accepting new patients
Alegent Creighton Clinic CurrentSince Jul 1, 2014 Accepting new patients
Alegent Creighton Health Past Accepting new patients

Locations

800 Mercy Dr
Council Bluffs, IA 51503
Phone (712) 328-5000

800 Mercy Dr
Ste 220
Council Bluffs, IA 51503
Phone (712) 388-2660

2771 Solution Ctr
Chicago, IL 60677

7261 Mercy Rd
Omaha, NE 68124
Phone (402) 398-6248

16909 Lakeside Hills Ct
Ste 401
Omaha, NE 68130
Phone (402) 827-4920

7710 Mercy Rd
Ste 426
Omaha, NE 68124
Phone (402) 343-8650

7101 Newport Ave
Omaha, NE 68152
Phone (402) 572-2905

7500 Mercy Rd
Omaha, NE 68124
Phone (402) 398-5880

16901 Lakeside Hills Ct
Omaha, NE 68130
Phone (402) 572-6500

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567987200000",
    "number": "1033128251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7261 MERCY RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242311",
            "telephone_number": "402-398-6255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16901 LAKESIDE HILLS CT",
            "address_2": "ATTN: HOSPITAL MEDICINE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681302318",
            "telephone_number": "402-398-6255",
            "fax_number": "402-829-8513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANESAN",
        "first_name": "JAYANTHI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2019-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "22567",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IA",
            "license": "MD-37779",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NE",
            "license": "22567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025027500",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.