Individual provider Active NPI

Anjan Talukdar, M.D.

  • Vascular Surgery Physician
  • Omaha, NE
National Provider Identifier
1346479706
Registry record updated Aug 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
30644 Issued in NE
Practice address
515 N 162ND Ave Ste 300
Omaha, NE 68118-2540
Phone
(402) 354-1200
Fax
(402) 354-1205
NPI assigned
Jul 7, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 64901-020 WI
Vascular Surgery Physician 2086S0129X MD-44973 IA
Vascular Surgery Physician 2086S0129X 30644 NE Primary

Addresses

Primary practice location

515 N 162ND Ave Ste 300
Omaha, NE 68118-2540

Mailing address

PO Box 3755
Omaha, NE 68103-0755
Phone (402) 354-2100

Other practice location 1

700 S Park St
Madison, WI 53715-1830
Phone (608) 260-2900

Other practice location 2

700 S Park St
Madison, WI 53715-1830
Phone (608) 260-2900

Other identifiers 6

IdentifierTypeStateIssuer
10026135100MedicaidNE
1346479706MedicaidIA
47068731713MedicaidNE
1346479706MedicaidWI
10026454700MedicaidNE
10026480122MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, NE2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180530000660 IA Practitioner - Vascular Surgery 6709001571 Reassigns benefits to 1 organization
I20180613003068 NE Practitioner - Vascular Surgery 6709001571 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physicians Clinic IncGroup PAC ID 4880506062, 557 clinicians

Practice addresses (Care Compare)

1 Edmundson PL
Council Bluffs, IA 51503-4658
Phone (712) 396-4000

1213 Garfield Ave
Harlan, IA 51537-2057
Phone (712) 755-5161

1501 E 10TH St
Cass County Memorial Hospital
Atlantic, IA 50022-1936
Phone (712) 243-3250

16120 W Dodge Rd
Omaha, NE 68118-2049
Phone (402) 354-0550

933 E Pierce St
Methodist Jennie Edmundson
Council Bluffs, IA 51503-4626
Phone (712) 396-7495

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal12
Leg revascularization (restoring blood flow)49
Removal of tissue19
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64901-020WIMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Clinic Inc CurrentSince Jun 30, 2018 Accepting new patients
Nebraska Methodist Hospital Past Accepting new patients

Locations

1 Edmundson Pl
Council Bluffs, IA 51503
Phone (712) 396-4000

1 Edmundson Pl
Ste 310
Council Bluffs, IA 51503
Phone (712) 328-1801

10060 Regency Cir
Omaha, NE 68114
Phone (402) 354-1405

515 N 162nd Ave
Ste 300
Omaha, NE 68118
Phone (402) 354-1200

16120 W Dodge Rd
Omaha, NE 68118
Phone (402) 354-0550

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 6

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": "1246924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564704000000",
    "number": "1346479706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3755",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681030755",
            "telephone_number": "402-354-2100",
            "fax_number": "402-354-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 N 162ND AVE STE 300",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681182540",
            "telephone_number": "402-354-1200",
            "fax_number": "402-354-1205"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 S Park St",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537151830",
            "country_code": "US",
            "telephone_number": "608-260-2900",
            "fax_number": "608-260-2961",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 S Park St",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537151830",
            "country_code": "US",
            "telephone_number": "608-260-2900",
            "fax_number": "608-260-2961",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TALUKDAR",
        "first_name": "ANJAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-07",
        "last_updated": "2019-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "WI",
            "license": "64901-020",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IA",
            "license": "MD-44973",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NE",
            "license": "30644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026135100",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346479706",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47068731713",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346479706",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026454700",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026480122",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.