Individual provider Active NPI

Juan Manuel Pernia, MD

  • Family Medicine Physician
  • Omaha, NE
National Provider Identifier
1306417225
Registry record updated Jul 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
TEP9018 Issued in NE
Practice address
7710 Mercy Rd Ste 202
Omaha, NE 68124-2353
Phone
(402) 280-4318
NPI assigned
Jul 2, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X TEP9018 NE Primary

Addresses

Primary practice location

7710 Mercy Rd Ste 202
Omaha, NE 68124-2353

Mailing address

7710 Mercy Rd Ste 202
Omaha, NE 68124-2353
Phone (402) 280-4318

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
I20240725004487 NE Practitioner - Family Practice 8022412402 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians
CHI Health Clinic Specialty LLCGroup PAC ID 4789098443, 317 clinicians

Practice addresses (Care Compare)

2510 S 40TH St
100 CHI Health Clinic
Lincoln, NE 68506-2408
Phone (402) 483-6000

555 S 70TH St
St Elizabeth Regional Med Center
Lincoln, NE 68510-2462
Phone (402) 219-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TEP9018NEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic Family Medicine CurrentSince Aug 20, 2024 Accepting new patients
CHI Health Clinic Specialty, LLC Family Medicine CurrentSince Aug 20, 2024 Accepting new patients
The Physician Network Family Medicine PastSince Sep 1, 2011 Accepting new patients
Alegent Creighton Clinic Family Medicine Past Accepting new patients
Saint Elizabeth Regional Medical Center Past Accepting new patients

Locations

2771 Solution Ctr
Chicago, IL 60677

555 S 70th St
Lincoln, NE 68510
Phone (402) 219-8000

8207 Northwoods Dr
Ste 100
Lincoln, NE 68505
Phone (402) 484-3440

2510 S 40th St
Ste 100
Lincoln, NE 68506
Phone (402) 483-6000

7440 S 91st St
Lincoln, NE 68526
Phone (402) 489-6554

16909 Lakeside Hills Ct
Ste 401
Omaha, NE 68130
Phone (402) 827-4920

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1625184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625184000000",
    "number": "1306417225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7710 MERCY RD STE 202",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242353",
            "telephone_number": "402-280-4318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7710 MERCY RD STE 202",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242353",
            "telephone_number": "402-280-4318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERNIA",
        "first_name": "JUAN",
        "middle_name": "MANUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-02",
        "last_updated": "2021-07-02",
        "certification_date": "2021-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "TEP9018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.