Individual provider Active NPI

Safana Anna Makhdoom

  • Family Medicine Physician
  • Omaha, NE
National Provider Identifier
1720311095
Registry record updated Sep 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
6164 Issued in NE
Practice address
University of Nebraska Medical Ctr
Dept. of Family Medicine 983075 Nebraska Medical Center
Omaha, NE 68198-3075
Phone
(402) 559-5641
NPI assigned
Sep 17, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 6164 NE Primary

Addresses

Primary practice location

University of Nebraska Medical Ctr
Dept. of Family Medicine 983075 Nebraska Medical Center
Omaha, NE 68198-3075

Mailing address

University of Nebraska Medical Ctr
Dept. of Family Medicine 983075 Nebraska Medical Center
Omaha, NE 68198-3075
Phone (402) 559-5641

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6164NEMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1253145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253145600000",
    "number": "1720311095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF NEBRASKA MEDICAL CTR",
            "address_2": "DEPT. OF FAMILY MEDICINE 983075 NEBRASKA MEDICAL CENTER",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681983075",
            "telephone_number": "402-559-5641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF NEBRASKA MEDICAL CTR",
            "address_2": "DEPT. OF FAMILY MEDICINE 983075 NEBRASKA MEDICAL CENTER",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681983075",
            "telephone_number": "402-559-5641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKHDOOM",
        "first_name": "SAFANA",
        "middle_name": "ANNA",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-17",
        "last_updated": "2009-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "6164",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.