Jane M. Carnazzo, M.D.
Individual provider Active NPI Pediatrics Physician · Omaha, NE
NPI 1093811069 · NPPES record last updated Sep 7, 2012
Key facts
- NPI
- 1093811069
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 17583 (NE)
- Practice address
- 4224 S 50TH St
Omaha, NE 68117-1332 - Phone
- (402) 955-7474
- Fax
- (402) 955-7476
- NPI assigned
- Sep 16, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17583 | NE | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S West Village Pointe - Diagnostic Services | Past | Accepting new patients | |
| Children'S Physicians | Pediatrics | Past | Accepting new patients |
| Nebraska Pediatric Practice, Inc | Pediatrics | Past | Accepting new patients |
| Alegent Health Bergan Mercy Health System | Past | Accepting new patients |
Interoperability endpoints
- jcarnazzo1010@direct.chsomaha.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 17583 | NE | Yes |
Addresses
Primary practice location
4224 S 50TH St
Omaha, NE 68117-1332
Mailing address
8401 W Dodge Rd
Suite 280
Omaha, NE 68114-3451
Phone (402) 955-6810
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31404 | Other | NE | BCBS |
| 47068937238 | Medicaid | NE | |
| 654 | Other | NE | MIDLANDS CHOICE |
| 950469 | Medicaid | IA | |
| 93491 | Other | IA | BCBS |
Other providers in Omaha, NE
- Eve Ngoc Carlton
- Carlye Travis DDS PC
- Tracy Lynn Carman
- Yaritza Carmona Gonzalez
- Yeni Carmona Gonzalez
- Joseph Carnazzo
- Will Carnazzo
- Ashley Renee Carne
- Denice Carne
- Amy Carnell
All providers in Omaha, NE · Pediatrics Physician in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 7, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.