Individual provider Active NPI

Peter P Cusumano, LMHP

  • Counselor
  • Omaha, NE
National Provider Identifier
1275756272
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
1818 Issued in NE
Practice address
16909 Lakeside Hills CT
Suite 400
Omaha, NE 68130-4664
Phone
(402) 758-5850
Fax
(402) 758-5855
NPI assigned
Apr 10, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 1818 NE Primary

Addresses

Primary practice location

16909 Lakeside Hills CT
Suite 400
Omaha, NE 68130-4664

Mailing address

PO Box 641130
Omaha, NE 68164-7130
Phone (402) 572-2907

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231215000854 NE Practitioner - Mental Health Counselor 5799134730 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton HealthGroup PAC ID 1850285255, 137 clinicians

Practice addresses (Care Compare)

16909 Lakeside Hills CT
Omaha, NE 68130-4664
Phone (402) 758-5850

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1818NEMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Health Counselor CurrentSince Jan 1, 2024 Accepting new patients
Alegent Creighton Health CurrentSince Jan 1, 2024 Accepting new patients
Alegent Health Immanuel Medical Center Past Accepting new patients

Locations

2771 Solution Ctr
Chicago, IL 60677

16909 Lakeside Hills Ct
Omaha, NE 68130
Phone (402) 758-5690

16909 Lakeside Hills Ct
Ste 400
Omaha, NE 68130
Phone (402) 758-5850

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

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275756272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 641130",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681647130",
            "telephone_number": "402-572-2907",
            "fax_number": "402-572-3544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16909 LAKESIDE HILLS CT",
            "address_2": "SUITE 400",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681304664",
            "telephone_number": "402-758-5850",
            "fax_number": "402-758-5855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSUMANO",
        "first_name": "PETER",
        "middle_name": "P",
        "credential": "LMHP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NE",
            "license": "1818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.