Organization
MARTIN M MANCUSO MD PC
Active
Organization
MARTIN M MANCUSO MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY DEROUCHEY (PRACTICE MANAGER)
(402) 330-0444
Entity
Organization
Contact information
Practice address
11704 W CENTER RD STE 210, OMAHA, NE 68144-4327
(402) 334-3377
(402) 691-9922
Mailing address
11704 W CENTER RD STE 210, OMAHA, NE 68144-4327
(402) 334-3377
(402) 691-9922
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
14017
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0903674
—
IA
01
—
828013494
TRAVELERS RR MEDICARE
NE
Enumeration date
09/11/2007
Last updated
08/07/2008
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up