Individual provider Active NPI

Renuga Vivekanandan, MD

  • Internal Medicine Physician
  • Omaha, NE
National Provider Identifier
1508003914
Registry record updated Jan 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5613 Issued in NE
Practice address
University of Nebraska
982055 Nebraska Medical Center
Omaha, NE 68198-0001
Phone
(402) 559-7792
Fax
(402) 559-9385
NPI assigned
Jan 8, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5613 NE Primary

Addresses

Primary practice location

University of Nebraska
982055 Nebraska Medical Center
Omaha, NE 68198-0001

Mailing address

1012 Douglas St
503
Omaha, NE 68102-1860
Phone (312) 543-9940

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
I20131015001717 NE Practitioner - Infectious Disease 1658505268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians

Practice addresses (Care Compare)

16901 Lakeside Hills CT
Omaha, NE 68130-2318
Phone (855) 524-4001

16909 Lakeside Hills CT
Omaha, NE 68130-4661

6901 N 72ND St
Omaha, NE 68122-1709

7500 Mercy Rd
Omaha, NE 68124-2319
Phone (402) 398-5580

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5613NEMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic CurrentSince Oct 1, 2013 Accepting new patients
Alegent Creighton Clinic Internal Medicine Past Accepting new patients

Locations

2771 Solution Ctr
Chicago, IL 60677

7261 Mercy Rd
Omaha, NE 68124
Phone (402) 398-6248

7710 Mercy Rd
Ste 3000
Omaha, NE 68124
Phone (402) 717-9600

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

Interoperability endpoints

  • Direct secure messaging: rvivekanandan46985@achce.catholichealth.net

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 4

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": "1231372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231372800000",
    "number": "1508003914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 DOUGLAS ST",
            "address_2": "503",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681021860",
            "telephone_number": "312-543-9940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF NEBRASKA",
            "address_2": "982055 NEBRASKA MEDICAL CENTER",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681980001",
            "telephone_number": "402-559-7792",
            "fax_number": "402-559-9385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIVEKANANDAN",
        "first_name": "RENUGA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-08",
        "last_updated": "2009-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "5613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.