Individual provider Active NPI

Daniel John Soden, PSYD

  • Clinical Neuropsychologist
  • Omaha, NE
National Provider Identifier
1891432209
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
Practice address
6829 N 72ND St Ste 4700
Omaha, NE 68122-1728
Phone
(402) 572-2169
Fax
(402) 572-3749
NPI assigned
May 17, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X Primary

Addresses

Primary practice location

6829 N 72ND St Ste 4700
Omaha, NE 68122-1728

Mailing address

6829 N 72ND St Ste 4700
Omaha, NE 68122-1728
Phone (402) 572-2169

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220829000261 NE Practitioner - Clinical Psychologist 3072997873 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2020
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)

6829 N 72ND St
Suite 4700
Omaha, NE 68122-1728
Phone (402) 572-2169

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic CurrentSince Sep 20, 2022 Accepting new patients
Alegent Creighton Clinic Past Accepting new patients
Alegent Health Immanuel Medical Center PastSince Aug 28, 2022 Accepting new patients

Locations

2771 Solution Ctr
Chicago, IL 60677

6829 N 72nd St
Ste 4700
Omaha, NE 68122
Phone (402) 572-2169

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1652745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1891432209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6829 N 72ND ST STE 4700",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681221728",
            "telephone_number": "402-572-2169",
            "fax_number": "402-572-3749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6829 N 72ND ST STE 4700",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681221728",
            "telephone_number": "402-572-2169",
            "fax_number": "402-572-3749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SODEN",
        "first_name": "DANIEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-17",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.