Active NPI
Eric Michael Samuelson, MD
- Sports Medicine (Orthopaedic Surgery) Physician
- Omaha, NE
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Orthopaedic Surgery) Physician
- License
- 27772
- Practice address
- 2725 S 144TH St Ste 212
Omaha, NE 68144-5253 - Phone
- (402) 637-0800
- Fax
- (402) 637-0808
- NPI assigned
- Apr 11, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 27772 | NE | |
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | 27772 | NE | Primary |
Addresses
Primary practice location
2725 S 144TH St Ste 212
Omaha, NE 68144-5253
Mailing address
2725 S 144TH St Ste 212
Omaha, NE 68144-5253
Phone (402) 637-0800
Other practice location 1
6829 N 72nd St
Suite 7500
Omaha, NE 68122-1723
Phone (402) 717-0820
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 27772 | Other | NE | NEBRASKA LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | onclinic@orthonebraska.cernerdirect.com |
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: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Sports Medicine
- Education
- University of Nebraska College of Medicine, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2725 S 144TH St
Suite 212
Omaha, NE 68144-5253
Phone (402) 609-3000
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Lower limb (leg) arthroscopy (minimally invasive joint repair) | 1-10 |
| Upper limb (arm) arthroscopy (minimally invasive joint repair) | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27772 | NE | MD | Sports Medicine (Orthopaedic Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthowest LLC | Orthopaedic Surgery | Current | Accepting new patients |
| Orthowest LLC | Orthopaedic Surgery | Current | Accepting new patients |
Locations
800 Mercy Dr
Ste 220
Council Bluffs, IA 51503
Phone (712) 388-2660
3415 S 205th St
Elkhorn, NE 68022
Phone (402) 609-1750
2540 N Healthy Way
Fremont, NE 68025
Phone (402) 721-3133
450 E 23rd St
Fremont, NE 68025
Phone (402) 721-1610
2725 S 144th St
Ste 212
Omaha, NE 68144
Phone (402) 354-4000
2725 S 144th St
Ste 110
Omaha, NE 68144
Phone (402) 637-0400
17701 Manderson St
Omaha, NE 68116
Organizations & group practices 2
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.
-
- Orthopaedic Surgery Physician
- Omaha, NE
- NPI 1275641904
-
- Durable Medical Equipment & Medical Supplies
- Omaha, NE
- NPI 1073323606
Orthopaedic Surgery
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Omaha, NE
- NPI 1356345318
-
- Critical Access Hospital
- Denison, IA
- NPI 1578555116
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656028800000",
"number": "1205050523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2725 S 144TH ST STE 212",
"city": "OMAHA",
"state": "NE",
"postal_code": "681445253",
"telephone_number": "402-637-0800",
"fax_number": "402-637-0808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2725 S 144TH ST STE 212",
"city": "OMAHA",
"state": "NE",
"postal_code": "681445253",
"telephone_number": "402-637-0800",
"fax_number": "402-637-0808"
}
],
"practiceLocations": [
{
"address_1": "6829 N 72nd St",
"address_2": "Suite 7500",
"address_purpose": "LOCATION",
"city": "Omaha",
"state": "NE",
"postal_code": "681221723",
"country_code": "US",
"telephone_number": "402-717-0820",
"fax_number": "402-717-6061",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SAMUELSON",
"first_name": "ERIC",
"middle_name": "MICHAEL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-11",
"last_updated": "2022-06-24",
"certification_date": "2022-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "NE",
"license": "27772",
"primary": false
},
{
"code": "207XX0005X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": "NE",
"license": "27772",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEBRASKA LICENSE",
"identifier": "27772",
"state": "NE"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "onclinic@orthonebraska.cernerdirect.com",
"affiliation": "N",
"address_1": "2725 S 144th St Ste 212",
"city": "Omaha",
"state": "NE",
"country_code": "US",
"postal_code": "681445253",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Jun 24, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.