Individual provider Active NPI

Juan Antonio Santamaria, MD

  • Surgical Oncology Physician
  • Omaha, NE
National Provider Identifier
1134474141
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
32613 Issued in NE
Practice address
111 N 175TH St
Omaha, NE 68118-3579
Phone
(402) 559-5600
NPI assigned
Jul 16, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X Q9021 TX
Surgical Oncology Physician 2086X0206X 32613 NE Primary

Addresses

Primary practice location

111 N 175TH St
Omaha, NE 68118-3579

Mailing address

988102 Nebraska Medical Ctr
Omaha, NE 68198-8102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NE2 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
I20190716003457 CA Practitioner - General Surgery 9739437971 Reassigns benefits to 2 organizations
I20201007002597 NE Practitioner - Surgical Oncology 9739437971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Surgical Oncology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unmc PhysiciansGroup PAC ID 6002728391, 1,490 clinicians

Practice addresses (Care Compare)

111 N 175TH St
Unmc Physicians Village Pointe Cancer Cente
Omaha, NE 68118-3579
Phone (402) 596-5600

Hospital & facility affiliations

  • The Nebraska Medical Center Hospital, Omaha, NE, CCN 280013
  • Bellevue Medical Center Hospital, Bellevue, NE, CCN 280132

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy40
Melanoma (skin cancer) excision32

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q9021TXMDSurgery Physician
32613NEMDSurgical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Specialists of California, PC CurrentSince Mar 1, 2020 Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 14, 2019 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Unmc Physicians CurrentSince Oct 1, 2020 Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 14, 2019 Accepting new patients
Haysam Akkad, MD, PC Past Accepting new patients

Locations

6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

111 N 175th St
Omaha, NE 68118
Phone (402) 559-8363

988102 Nebraska Medical Ctr
Omaha, NE 68198
Phone (402) 559-5600

Emile 42nd St
Omaha, NE 68198
Phone (402) 552-6731

505 S 45th St
Omaha, NE 68198
Phone (402) 559-0900

Organizations & group practices 6

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 2

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": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1134474141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988102 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681988102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N 175TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681183579",
            "telephone_number": "402-559-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTAMARIA",
        "first_name": "JUAN",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-16",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "Q9021",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "NE",
            "license": "32613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.