MARTIN M MANCUSO MD PC NPI 1326233545

NPI Information

  • NPI: 1326233545
  • Provider Name: MARTIN M MANCUSO MD PC
  • Classification: Internal Medicine - 207R00000X
  • Entity Type: Organization
  • Address: 11704 W CENTER RD STE 210
    OMAHA, NE
    ZIP 68144
  • Phone: (402) 334-3377

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NPI Details

MARTIN M MANCUSO MD PC is an internal medicine in Omaha, NE. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. MARTIN M MANCUSO MD PC NPI is 1326233545. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

11704 W CENTER RD STE 210
OMAHA, NE
ZIP 68144-327
Phone: (402) 334-3377
Fax: (402) 691-9922

The provider's authorized official is Mary Derouchey .
The authorized official title is Practice Manager and has the following contact phone number (402) 330-0444.

The enumeration date for this NPI number is 9/11/2007 and was last updated on 8/7/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal Medicine14017NEBRASKAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1D92381MEDICARE UPIN
2900041MEDICARE PIN
3828013494OTHERNEBRASKATRAVELERS RR MEDICARE
40903674MEDICAIDIOWA
5=========00MEDICAIDNEBRASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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