Active NPI
Daniel D Lydiatt, M.D.
- Surgery Physician
- Omaha, NE
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 16395
- Practice address
- 8303 Dodge St
Omaha, NE 68114-4108 - Phone
- (402) 354-5048
- Fax
- (402) 354-2585
- NPI assigned
- Apr 21, 2006
- Last updated
- Dec 13, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 16395 | NE | |
| Otolaryngology Physician | 207Y00000X | 16395 | NE | |
| Radiation Oncology Physician | 2085R0001X | 16395 | NE | |
| Surgery Physician | 208600000X | 16395 | NE | Primary |
Addresses
Primary practice location
8303 Dodge St
Omaha, NE 68114-4108
Mailing address
PO Box 10190
Virginia Beach, VA 23450-0190
Phone (800) 477-5240
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417913302 | Medicaid | IA | |
| 10025044400 | Medicaid | NE |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16395 | NE | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Unmc Physicians | Current | Accepting new patients | |
| Physicians Clinic, Inc. | Past | Accepting new patients | |
| Physicians Clinic Inc | Otolaryngology | Past | Accepting new patients |
Locations
8303 W Dodge Rd
Omaha, NE 68114
Phone (402) 354-4000
987400 Nebraska Medical Ctr
Omaha, NE 68198
Phone (402) 559-3405
Emile 42nd St
Omaha, NE 68198
Phone (402) 552-6731
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.
-
- Multi-Specialty Clinic/Center
- Omaha, NE
- NPI 1417912114
-
dba Methodist Physicians Clinic
- Family Medicine Physician
- Omaha, NE
- NPI 1821049156
Otolaryngology
-
dba Methodist Physicians Clinic
- Durable Medical Equipment & Medical Supplies
- Omaha, NE
- NPI 1770673923
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386892800000",
"number": "1417913302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10190",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234500190",
"telephone_number": "800-477-5240",
"fax_number": "757-463-6572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8303 DODGE ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681144108",
"telephone_number": "402-354-5048",
"fax_number": "402-354-2585"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYDIATT",
"first_name": "DANIEL",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-21",
"last_updated": "2013-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "NE",
"license": "16395",
"primary": false
},
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "NE",
"license": "16395",
"primary": false
},
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": "NE",
"license": "16395",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NE",
"license": "16395",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1417913302",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025044400",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.