NPIMap

Organization Active NPI

Crete Area Medical Center

  • Critical Access Hospital
  • Crete, NE
National Provider Identifier
1063463958
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
670001 Issued in NE
Legal business name
CRETE AREA MEDICAL CENTER
Practice address
2910 Betten Dr
Crete, NE 68333-3084
Phone
(402) 826-2102
Fax
(402) 826-7950
NPI assigned
May 15, 2006
Last updated
Nov 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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

Authorized official

Name
Julie Lacy
Title
President & Ceo
Phone
(402) 826-2102

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 670001 NE Primary

Addresses

Primary practice location

2910 Betten Dr
Crete, NE 68333-3084

Mailing address

PO Box 860873
Minneapolis, MN 55486-0873
Phone (402) 826-2102

Other identifiers 3

IdentifierTypeStateIssuer
52OtherNEMIDLANDS CHOICE
5000037OtherNEUNITED HEALTH CARE
00025OtherNEBCBS OF NEBRASKA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@hisp.bryanhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071129000277 NE Part A Provider - Critical Access Hospital 4385556216 Receives reassigned benefits from 39 practitioners
Practice locations: Crete, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063463958. Details of each certification follow.

Hospital certification: CCN 281354

Legal name
CRETE AREA MEDICAL CENTER
Doing business as
CRETE AREA MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Feb 1, 2002
Last certification
Apr 16, 2026
Beds
15
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Apr 23, 2001 in NE
Enrollment address
2910 Betten Dr
Crete, NE 68333-3084
Other Hospital Practice Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Crete Area Medical CenterCCN 281354 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Crete Area Medical Center6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Michael J Kozisek Individual Corporate Officer Jan 1, 2024
Corporate Director Jan 1, 2023
Maria Isquierdo Individual Corporate Director Jan 1, 2022
Jason K Hesser Individual Corporate Director Jan 1, 2023
W-2 Managing EmployeeChief of Staff Jan 1, 2023
Operational/Managerial ControlChief of Staff Jan 1, 2023
Eric S Post Individual Corporate Officer Jan 1, 2024
Corporate Director Jan 1, 2023
Patrick D Ganyo Individual Corporate Director Jul 1, 2024
Bryan Health Organization, Lincoln, NE Corporation, Non-profit, Chain home office Operational/Managerial Control Feb 1, 2002
Julie Lacy Individual Corporate OfficerPresident & Ceo Jul 1, 2024
Corporate DirectorPresident & Ceo Jul 1, 2024
W-2 Managing EmployeePresident & Ceo Jul 1, 2024
Operational/Managerial ControlPresident & Ceo Jul 1, 2024
David K Newmyer Individual Corporate Director Jan 1, 2024
Guadalupe C Avelar Individual Corporate Officer Jan 1, 2023
Corporate Director Jan 1, 2020

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 17

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 17

Subparts reporting this organization as parent 5

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 39

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.

View all 39

Affiliated clinicians 98

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 98

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732492800000",
    "number": "1063463958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860873",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554860873",
            "telephone_number": "402-826-2102",
            "fax_number": "402-826-7950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 BETTEN DR",
            "city": "CRETE",
            "state": "NE",
            "postal_code": "683333084",
            "telephone_number": "402-826-2102",
            "fax_number": "402-826-7950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRETE AREA MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A",
        "authorized_official_last_name": "LACY",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "402-826-2102"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NE",
            "license": "670001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "52",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "5000037",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NEBRASKA",
            "identifier": "00025",
            "state": "NE"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@hisp.bryanhealth.org",
            "affiliation": "N",
            "address_1": "1600 S 48th St",
            "city": "Lincoln",
            "state": "NE",
            "country_code": "US",
            "postal_code": "685061299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crete, NE

Sources for this page

Verify at the official NPI Registry.