Individual provider Active NPI

Michael Donald Triassi, DO

  • Family Medicine Physician
  • Offutt Afb, NE
National Provider Identifier
1902300577
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2231 Issued in NE
Practice address
2501 Capehart Rd
Offutt Afb, NE 68113-1043
Phone
(402) 232-9415
NPI assigned
Mar 20, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 2231 NE Primary

Addresses

Primary practice location

2501 Capehart Rd
Offutt Afb, NE 68113-1043

Mailing address

2501 Capehart Rd
Offutt Afb, NE 68113-1043
Phone (402) 232-9415

Other practice location 1

2261 Philadelphia Dr Ste 301
Dayton, OH 45406-1814
Phone (937) 734-4141

Other practice location 2

4881 Sugar Maple Dr
Wright Patterson AFB, OH 45433-5529
Phone (937) 257-8715

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
I20220413000338 NE Practitioner - Family Practice 5698022390 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2231NEMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Unmc Physicians CurrentSince Apr 1, 2022 Accepting new patients

Locations

2510 Bellevue Medical Center Dr
Ste 200
Bellevue, NE 68123
Phone (402) 595-2275

Emile 42nd St
Omaha, NE 68198
Phone (402) 552-6731

988102 Nebraska Medical Ctr
Omaha, NE 68198
Phone (402) 559-5600

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.

NPI Registry JSON

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

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1902300577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 CAPEHART RD",
            "city": "OFFUTT AFB",
            "state": "NE",
            "postal_code": "681131043",
            "telephone_number": "402-232-9415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 CAPEHART RD",
            "city": "OFFUTT AFB",
            "state": "NE",
            "postal_code": "681131043",
            "telephone_number": "402-232-9415"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2261 Philadelphia Dr Ste 301",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454061814",
            "country_code": "US",
            "telephone_number": "937-734-4141",
            "fax_number": "937-277-7249",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4881 Sugar Maple Dr",
            "address_purpose": "LOCATION",
            "city": "Wright Patterson AFB",
            "state": "OH",
            "postal_code": "454335529",
            "country_code": "US",
            "telephone_number": "937-257-8715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRIASSI",
        "first_name": "MICHAEL",
        "middle_name": "DONALD",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-20",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "2231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Offutt Afb, NE

Sources for this page

Verify at the official NPI Registry.