Organization Active NPI

Robert J Zadalis MD PC

  • Surgery Physician
  • Omaha, NE
National Provider Identifier
1972646339
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
20318 Issued in NE
Legal business name
ROBERT J ZADALIS MD PC
Practice address
6828 N 72 St
#5500
Omaha, NE 68122
Phone
(402) 572-3663
Fax
(402) 572-3438
NPI assigned
Feb 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Robert J Zadalis, MDNPI 1982620639
Title
President
Phone
(402) 572-3663

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
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 20318 NE Primary

Addresses

Primary practice location

6828 N 72 St
#5500
Omaha, NE 68122

Mailing address

6828 N 72 St
#5500
Omaha, NE 68122
Phone (402) 572-3663

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040602001585 NE Part B Supplier - Clinic/Group Practice 8729060827 Receives reassigned benefits from 2 practitioners
Practice locations: Omaha, NE

National Provider Directory

National Provider Directory

Locations

17001 Lakeside Hills Plz
Ste 102
Omaha, NE 68130
Phone (402) 934-6996

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972646339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6828 N 72 ST",
            "address_2": "#5500",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68122",
            "telephone_number": "402-572-3663",
            "fax_number": "402-572-3438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6828 N 72 ST",
            "address_2": "#5500",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68122",
            "telephone_number": "402-572-3663",
            "fax_number": "402-572-3438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT J ZADALIS MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ZADALIS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-572-3663",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "NE",
            "license": "20318",
            "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 Aug 22, 2020; 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.