NPIMap

Organization Active NPI

Omaha Foot and Ankle Specialists PC

  • Foot Surgery Podiatrist
  • Omaha, NE
National Provider Identifier
1730289125
Registry record updated Jun 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
220 Issued in NE
Legal business name
OMAHA FOOT AND ANKLE SPECIALISTS PC
Practice address
16909 Burke St.
Suite 200
Omaha, NE 68118
Phone
(402) 333-8856
Fax
(402) 333-3428
NPI assigned
Sep 25, 2006
Last updated
Jun 14, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2018

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

Authorized official

Name
Michael P Cullen, DPMNPI 1851329114
Title
Owner
Phone
(402) 333-8856

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X 220 NE Primary

Addresses

Primary practice location

16909 Burke St.
Suite 200
Omaha, NE 68118

Mailing address

16909 Burke St.
Suite 200
Omaha, NE 68118
Phone (402) 333-8856

Other identifiers 1

IdentifierTypeStateIssuer
DA4693OtherNEMEDICARE RR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081230000341 NE Part B Supplier - Clinic/Group Practice 8729140736 Receives reassigned benefits from 2 practitioners
Practice locations: Omaha, NE

National Provider Directory

National Provider Directory

Locations

16909 Burke St
Ste 200
Omaha, NE 68118
Phone (402) 333-8856

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528934400000",
    "number": "1730289125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16909 BURKE ST.",
            "address_2": "SUITE 200",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68118",
            "telephone_number": "402-333-8856",
            "fax_number": "402-333-3428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16909 BURKE ST.",
            "address_2": "SUITE 200",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68118",
            "telephone_number": "402-333-8856",
            "fax_number": "402-333-3428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMAHA FOOT AND ANKLE SPECIALISTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2018-06-14",
        "status": "A",
        "authorized_official_last_name": "CULLEN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-333-8856",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NE",
            "license": "220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "DA4693",
            "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 Jun 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.