Individual provider Active NPI

Jose David Soriano, PLMHP

  • Mental Health Counselor
  • Omaha, NE
National Provider Identifier
1366719502
Registry record updated May 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
10487 Issued in NE
Practice address
4920 S 30TH St
#103
Omaha, NE 68107-1590
Phone
(402) 734-4110
NPI assigned
Nov 16, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 10487 NE Primary

Addresses

Primary practice location

4920 S 30TH St
#103
Omaha, NE 68107-1590

Mailing address

4920 S 30TH St
#103
Omaha, NE 68107-1590
Phone (402) 734-4110

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
I20240320002201 NE Practitioner - Mental Health Counselor 9830536382 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10487NEMDMental Health Counselor
2291NEMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Oneworld Community Health Centers, Inc. CurrentSince Jan 31, 2024 Accepting new patients
Oneworld Community Health Centers, Inc. CurrentSince Jan 31, 2024 Accepting new patients

Locations

4920 S 30th St
Ste 103
Omaha, NE 68107

122 S 6th St
Plattsmouth, NE 68048
Phone (402) 296-2345

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.

NPI Registry JSON

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

{
    "created_epoch": "1321401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432684800000",
    "number": "1366719502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4920 S 30TH ST",
            "address_2": "#103",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681071590",
            "telephone_number": "402-734-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4920 S 30TH ST",
            "address_2": "#103",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681071590",
            "telephone_number": "402-734-4110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORIANO",
        "first_name": "JOSE",
        "middle_name": "DAVID",
        "credential": "PLMHP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-16",
        "last_updated": "2015-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "10487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.