Active NPI
Plastic Surgical Arts PC
- Plastic Surgery Physician
- Lincoln, NE
National Provider Identifier
1013936012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- Legal business name
- PLASTIC SURGICAL ARTS PC
- Practice address
- 4400 Lucile Dr Ste 103
Lincoln, NE 68516-4211 - Phone
- (402) 483-2572
- Fax
- (402) 483-2619
- NPI assigned
- Jul 19, 2006
- Last updated
- Oct 31, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tina Olivares
- Title
- Manager
- Phone
- (402) 483-2572
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | Primary |
Addresses
Primary practice location
4400 Lucile Dr Ste 103
Lincoln, NE 68516-4211
Mailing address
4400 Lucile Dr Ste 103
Lincoln, NE 68516-4211
Phone (402) 483-2572
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CG2908 | Other | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
1730 S 70th St
Ste 210
Lincoln, NE 68506
Phone (402) 483-2572
4400 Lucile Dr
Ste 103
Lincoln, NE 68516
Phone (402) 483-2572
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Plastic Surgery Physician
- Lincoln, NE
- NPI 1104845148
-
- Plastic Surgery Physician
- Lincoln, NE
- NPI 1578588257
-
- Plastic Surgery Physician
- Lincoln, NE
- NPI 1487679163
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1730332800000",
"number": "1013936012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4400 LUCILE DR STE 103",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685164211",
"telephone_number": "402-483-2572",
"fax_number": "402-483-2619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4400 LUCILE DR STE 103",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685164211",
"telephone_number": "402-483-2572",
"fax_number": "402-483-2619"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PLASTIC SURGICAL ARTS PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-19",
"last_updated": "2024-10-31",
"certification_date": "2024-10-31",
"status": "A",
"authorized_official_last_name": "OLIVARES",
"authorized_official_first_name": "TINA",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "402-483-2572"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Plastic Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CG2908",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lincoln, NE
- Randall Raymond Plambeck, MD
- Robert Dean Plambeck Jr., MD
- Planned Parenthood of Nebraska and Council Bluffs
- Planned Parenthood of the Heartland, Inc
- Ner Plar
- Farrah Lynn Plate, DDS
- Ethan Micheal Platt, AUD
- Emily Kate Plautz, PA-C
- Play Therapy Omaha Inc. (Play Therapy Lincoln)
- Plaza West Psychiatrists
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; 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.