Individual provider Active NPI

Perry J Johnson, MD

  • Plastic Surgery Physician
  • Omaha, NE
National Provider Identifier
1306895610
Registry record updated Jun 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
18651 Issued in NE
Practice address
988102 Nebraska Medical Ctr
Omaha, NE 68198-8102
Phone
(402) 559-8363
Fax
(402) 559-9513
NPI assigned
May 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 18651 NE
Plastic and Reconstructive Surgery Physician 2086S0122X 18651 NE
Plastic Surgery Physician 208200000X 18651 NE Primary

Addresses

Primary practice location

988102 Nebraska Medical Ctr
Omaha, NE 68198-8102

Mailing address

988102 Nebraska Medical Ctr
Omaha, NE 68198-8102
Phone (402) 559-8363

Other identifiers 1

IdentifierTypeStateIssuer
47078557586MedicaidNE

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
I20100129000676 NE Practitioner - Plastic and Reconstructive SurgeryPractitioner - General Surgery 4688717614 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: General Surgery
Education
University of Kansas School of Med (KC/Wich/Sal), 1990
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)

17617 Burke St
Omaha, NE 68118-2259
Phone (402) 596-4000

987400 Nebraska Medical Ctr
Unmc Physicians Nebraska Medical Center
Omaha, NE 68198-7400
Phone (402) 559-4000

Emile 42ND St
Omaha, NE 68198-0001
Phone (402) 559-4015

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision18
Removal of tissue1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18651NEMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unmc Physicians CurrentSince Jul 1, 1997 Accepting new patients

Locations

17617 Burke St
Omaha, NE 68118
Phone (402) 595-4014

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

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

Interoperability endpoints

  • Direct secure messaging: pjohnson2539@direct.nebraskamed.com

Organizations & group practices 1

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 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": "1146873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309305600000",
    "number": "1306895610",
    "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",
            "telephone_number": "402-559-8363",
            "fax_number": "402-559-9513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "988102 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681988102",
            "telephone_number": "402-559-8363",
            "fax_number": "402-559-9513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PERRY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-06",
        "last_updated": "2011-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NE",
            "license": "18651",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NE",
            "license": "18651",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NE",
            "license": "18651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47078557586",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.