Individual provider Active NPI

Holly Lynn Groteluschen, MD

  • Family Medicine Physician
  • Kearney, NE
National Provider Identifier
1104449149
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35789 Issued in NE
Practice address
211 W 33Rd St
Kearney, NE 68845-3484
Phone
(308) 865-2141
NPI assigned
May 26, 2020
Last updated
Jan 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 8713 NE
Family Medicine Physician 207Q00000X 35789 NE Primary

Addresses

Primary practice location

211 W 33Rd St
Kearney, NE 68845-3484

Mailing address

211 W 33Rd St
Kearney, NE 68845-3484
Phone (308) 865-2141

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230906001799 NE Practitioner - Family Practice 2769801794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Nebraska College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians

Practice addresses (Care Compare)

211 W 33Rd St
Kearney, NE 68845-3484
Phone (308) 865-2141

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic Family Medicine CurrentSince Sep 19, 2023 Accepting new patients
Good Samaritan Hospital Past Accepting new patients
Bryan Hospital Kearney Past Accepting new patients
Alegent Creighton Clinic Family Medicine Past Accepting new patients

Locations

2771 Solution Ctr
Chicago, IL 60677

3308 Samson Way
Bellevue, NE 68123
Phone (402) 291-3373

211 W 33rd St
Kearney, NE 68845
Phone (308) 236-5884

7261 Mercy Rd
Omaha, NE 68124
Phone (402) 398-6248

Organizations & group practices 4

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 2

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": "1590451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1104449149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 W 33RD ST",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688453484",
            "telephone_number": "308-865-2141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 W 33RD ST",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688453484",
            "telephone_number": "308-865-2141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROTELUSCHEN",
        "first_name": "HOLLY",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-26",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "8713",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "35789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearney, NE

Sources for this page

Verify at the official NPI Registry.