Individual provider Active NPI

Andrea L Lawlor, M.D.

  • Family Medicine Physician
  • Omaha, NE
National Provider Identifier
1104911296
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
22230 Issued in NE
Practice address
12728 Augusta Avenue
Omaha, NE 68144-3752
Phone
(402) 330-1410
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 22230 NE Primary

Addresses

Primary practice location

12728 Augusta Avenue
Omaha, NE 68144-3752

Mailing address

12728 Augusta Avenue
Omaha, NE 68144-3752
Phone (402) 330-1410

Other identifiers 5

IdentifierTypeStateIssuer
75304640000MedicaidNE
0104995OtherUNITED HEALTHCARE
92074OtherIAWELLMARK BCBS IA
06064OtherNEBLUE CROSS & BLUE SHIELD
4557165MedicaidIA

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
I20040426001179 NE Practitioner - Family Practice 8022005867 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Nebraska College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Clinic IncGroup PAC ID 4880506062, 557 clinicians
Primary Care Physicians LLPGroup PAC ID 3779548839, 6 clinicians

Practice addresses (Care Compare)

10060 Regency Cir
Omaha, NE 68114-3732
Phone (402) 354-1570

12728 Augusta Ave
Omaha, NE 68144-3754
Phone (402) 330-1410

717 N 190TH PLZ
Suite 1100
Elkhorn, NE 68022-3917
Phone (402) 815-1700

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Clinic Inc Family Medicine CurrentSince Jul 1, 2004 Accepting new patients
Primary Care Physicians, LLP CurrentSince Dec 1, 2004 Accepting new patients
Nebraska Methodist Hospital Current Accepting new patients
Burton Prosthetics Inc Past Accepting new patients
Alegent Creighton Clinic Family Medicine Past Accepting new patients
Family Medicine and Surgery PC Past Accepting new patients
Alegent Creighton Clinic Family Medicine Past Accepting new patients

Locations

810 N 22nd St
Blair, NE 68008
Phone (402) 426-1116

812 N 22nd St
Blair, NE 68008
Phone (402) 426-4611

10060 Regency Cir
Omaha, NE 68114
Phone (402) 354-1405

10710 Fort St
Omaha, NE 68134
Phone (402) 354-7500

12728 Augusta Ave
Omaha, NE 68144
Phone (402) 330-1410

Interoperability endpoints

  • Direct secure messaging: andrea.lawlor@direct.nmhs.org
  • Direct secure messaging: andrea.lawlor@primarycarephysicians.cernerdirect.com

Organizations & group practices 7

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.

Hospital & facility affiliations 6

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104911296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12728 AUGUSTA AVENUE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681443752",
            "telephone_number": "402-330-1410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12728 AUGUSTA AVENUE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681443752",
            "telephone_number": "402-330-1410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWLOR",
        "first_name": "ANDREA",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "22230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "75304640000",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0104995",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS IA",
            "identifier": "92074",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "06064",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4557165",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.