Individual provider Active NPI

Hoang Ngoc Nguyen Mai, MD

  • Family Medicine Physician
  • Omaha, NE
National Provider Identifier
1215457189
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
32 Issued in NE
Practice address
16909 Lakeside Hills CT Ste 300
Omaha, NE 68130-4661
Phone
(402) 758-5400
NPI assigned
Jun 22, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R-11041 IA
Family Medicine Physician 207Q00000X 32 NE Primary

Addresses

Primary practice location

16909 Lakeside Hills CT Ste 300
Omaha, NE 68130-4661

Mailing address

7261 Mercy Rd
Omaha, NE 68124-2311

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200820002882 NE Practitioner - Family Practice 4284993601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Nebraska College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians

Practice addresses (Care Compare)

16909 Lakeside Hills CT
Suite 300
Omaha, NE 68130-4661
Phone (402) 758-5400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32NEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic Family Medicine CurrentSince Sep 1, 2020 Accepting new patients
Alegent Creighton Clinic Family Medicine Past Accepting new patients

Locations

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

16909 Lakeside Hills Ct
Ste 300
Omaha, NE 68130
Phone (402) 758-5400

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.

Hospital & facility affiliations 3

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": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1215457189",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16909 LAKESIDE HILLS CT STE 300",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681304661",
            "telephone_number": "402-758-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAI",
        "first_name": "HOANG NGOC",
        "middle_name": "NGUYEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-22",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "R-11041",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "32",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.