Individual provider Active NPI

J Paul Cook, M.D.

  • Family Medicine Physician
  • Omaha, NE
National Provider Identifier
1780659367
Registry record updated Oct 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20903 Issued in NE
Practice address
17241 Oak Drive
Suite 101
Omaha, NE 68130-2202
Phone
(402) 896-1242
Fax
(402) 896-8948
NPI assigned
Feb 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2014

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 20903 NE Primary

Addresses

Primary practice location

17241 Oak Drive
Suite 101
Omaha, NE 68130-2202

Mailing address

17241 Oak Drive
Suite 101
Omaha, NE 68130-2202
Phone (402) 896-1242

Other identifiers 1

IdentifierTypeStateIssuer
47073659713MedicaidNE

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
I20100626000308 NE Practitioner - Family Practice 6406983931 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Nebraska College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Medicine Associates Millard-Gretna P CGroup PAC ID 4981731411, 4 clinicians

Practice addresses (Care Compare)

17241 Oak Dr
Suite 101
Omaha, NE 68130-2202
Phone (402) 896-1242

Hospital & facility affiliations

  • CHI Health Lakeside Hospital, Omaha, NE, CCN 280130
  • CHI Health Midlands Hospital, Papillion, NE, CCN 280105

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20903NEMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medicine Associates Millard-Gretna, P C Family Medicine CurrentSince Aug 8, 1983 Accepting new patients

Locations

17241 Oak Dr
Ste 101
Omaha, NE 68130
Phone (402) 896-1242

Organizations & group practices 1

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 2

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": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414108800000",
    "number": "1780659367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17241 OAK DRIVE",
            "address_2": "SUITE 101",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681302202",
            "telephone_number": "402-896-1242",
            "fax_number": "402-896-8948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17241 OAK DRIVE",
            "address_2": "SUITE 101",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681302202",
            "telephone_number": "402-896-1242",
            "fax_number": "402-896-8948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "J",
        "middle_name": "PAUL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2014-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "20903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47073659713",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.