Provider Demographics
NPI:1750324885
Name:CRITICAL CARE ASSOCIATES LLP
Entity Type:Organization
Organization Name:CRITICAL CARE ASSOCIATES LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:R
Authorized Official - Last Name:NOVOA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-391-3387
Mailing Address - Street 1:900 SO 74 PLZ
Mailing Address - Street 2:SUITE 108
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-4648
Mailing Address - Country:US
Mailing Address - Phone:402-391-3387
Mailing Address - Fax:402-391-7821
Practice Address - Street 1:7500 MERCY RD
Practice Address - Street 2:ALEGENT HEALTH BERGAN MERCY EMERGENCY DEPT
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124
Practice Address - Country:US
Practice Address - Phone:402-398-6161
Practice Address - Fax:402-398-6982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
002475OtherRAILROAD MEDICARE
002475OtherRAILROAD MEDICARE
NE=========13Medicaid
IA=========13Medicaid