NPIMap

Individual provider Active NPI

Wade Fornander, M.D.

  • Family Medicine Physician
  • Lincoln, NE
National Provider Identifier
1053383554
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
22563 Issued in NE
Practice address
4600 Valley Rd
Lincoln, NE 68510-4855
Phone
(402) 483-4571
Fax
(308) 344-8369
NPI assigned
Feb 7, 2006
Last updated
Apr 21, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 22563 NE Primary

Addresses

Primary practice location

4600 Valley Rd
Lincoln, NE 68510-4855

Mailing address

1401 E H St
MC Cook, NE 69001-3432
Phone (308) 344-4110

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wade.fornander.1@9271.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050729000399 NE Practitioner - Family Practice 7012945249 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Nebraska College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lincoln Medical Education PartnershipGroup PAC ID 4880645407, 16 clinicians

Practice addresses (Care Compare)

100 Hospital Dr
Pender, NE 68047-4507
Phone (402) 385-3083

4600 Valley Rd
Suite 200
Lincoln, NE 68510-4882
Phone (402) 483-4571

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
22563NEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jennie M Melham Memorial Medical Center Inc CurrentSince Dec 24, 2021 Accepting new patients
Jennie M Melham Memorial Medical Center Inc Current Accepting new patients
Pender Community Hospital District Current Accepting new patients
York General Hospital CurrentSince Aug 2, 2025 Accepting new patients
Providence Medical Center Current Accepting new patients
York General Hospital CurrentSince Aug 2, 2025 Accepting new patients
York General Hospital CurrentSince Aug 2, 2025 Accepting new patients
Saint Elizabeth Regional Medical Center Past Accepting new patients
Bryan Medical Center Past Accepting new patients

Locations

4600 Valley Rd
Lincoln, NE 68510
Phone (402) 483-4571

4600 Valley Rd
Ste 200
Lincoln, NE 68510
Phone (402) 483-4571

100 Hospital Dr
Pender, NE 68047
Phone (402) 385-3083

1200 Providence Rd
Wayne, NE 68787
Phone (402) 375-3800

2222 N Lincoln Ave
York, NE 68467
Phone (402) 362-0420

Networks

  • IA HMO C-SNP
  • CO HMO
  • IA HMO

Interoperability endpoints

  • Direct secure messaging: wade.fornander.1@9271.direct.athenahealth.com

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1053383554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 E H ST",
            "city": "MC COOK",
            "state": "NE",
            "postal_code": "690013432",
            "telephone_number": "308-344-4110",
            "fax_number": "308-344-8369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 VALLEY RD",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685104855",
            "telephone_number": "402-483-4571",
            "fax_number": "308-344-8369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORNANDER",
        "first_name": "WADE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "22563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wade.fornander.1@9271.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "4600 Valley Rd",
            "city": "Lincoln",
            "state": "NE",
            "country_code": "US",
            "postal_code": "685104855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.