Provider Demographics
NPI:1396704854
Name:O'NEIL, MICHAEL T (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:T
Last Name:O'NEIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2725 S 144TH ST STE 212
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-5253
Mailing Address - Country:US
Mailing Address - Phone:402-637-0800
Mailing Address - Fax:402-637-0808
Practice Address - Street 1:2725 S 144TH ST
Practice Address - Street 2:#110
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-5243
Practice Address - Country:US
Practice Address - Phone:402-637-0400
Practice Address - Fax:402-637-0401
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20601207X00000X
NE11052207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE0900228OtherAMERICHOICE-2725 S 144
IA0915686Medicaid
IA200046306OtherRAILROAD MEDICARE
IA3531707Medicaid
NE200011553OtherRAILROAD MEDICARE
IA33565OtherWELLMARK-CLARINDA
NE0900228OtherAMERICHOICE-2725 S 144
IA0915686Medicaid
IA200046306OtherRAILROAD MEDICARE
NE200011553OtherRAILROAD MEDICARE
NEE62087Medicare UPIN