Individual provider Active NPI

Mathieu Lane Hinze, MD

  • Plastic Surgery Physician
  • Lincoln, NE
National Provider Identifier
1104845148
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
15894 Issued in NE
Practice address
4400 Lucile Dr Ste 103
Lincoln, NE 68516-4211
Phone
(402) 483-2572
Fax
(402) 483-2619
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 15894 NE 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 7

IdentifierTypeStateIssuer
1013936012MedicaidNE
P00230083OtherRR MEDICARE PERFORMING #
1300171OtherUNITED HEALTH CARE
47066039913MedicaidNE
07373OtherBLUE CROSS BLUE SHIELD
247054OtherMIDLANDS CHOICE PPO
CG2908OtherRAILROAD MEDICARE GROUP #

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL www.psa.phiportal.com Direct

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
I20050727000473 NE Practitioner - Plastic and Reconstructive Surgery 2961491329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Nebraska College of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Plastic Surgical Arts PCGroup PAC ID 8123055225, 2 clinicians

Practice addresses (Care Compare)

4400 Lucile Dr
Suite 103
Lincoln, NE 68516-4211
Phone (402) 483-2572

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Plastic Surgical Arts PC Plastic Surgery CurrentSince Jul 1, 2005 Accepting new patients
Sjmgroup Past Accepting new patients

Locations

4400 Lucile Dr
Ste 103
Lincoln, NE 68516
Phone (402) 483-2572

1730 S 70th St
Ste 210
Lincoln, NE 68506
Phone (402) 483-2572

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1104845148",
    "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": {
        "last_name": "HINZE",
        "first_name": "MATHIEU",
        "middle_name": "LANE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NE",
            "license": "15894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013936012",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PERFORMING #",
            "identifier": "P00230083",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "1300171",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47066039913",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "07373",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE PPO",
            "identifier": "247054",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP #",
            "identifier": "CG2908",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.psa.phiportal.com",
            "affiliation": "N",
            "endpointDescription": "www.psa.phiportal.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4400 Lucile Dr Ste 103",
            "city": "Lincoln",
            "state": "NE",
            "country_code": "US",
            "postal_code": "685164211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.