NPIMap

Individual provider Active NPI

Sally Knooihuizen, MD

  • Gastroenterology Physician
  • Lincoln, NE
National Provider Identifier
1164943171
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
35811 Issued in NE
Practice address
4545 R St
Lincoln, NE 68503-3799
Phone
(402) 465-4545
Fax
(402) 465-9011
NPI assigned
Jun 29, 2017
Last updated
Oct 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 35811 NE Primary

Addresses

Primary practice location

4545 R St
Lincoln, NE 68503-3799

Mailing address

4545 R St
Lincoln, NE 68503-3799
Phone (402) 465-4545

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
I20230818001815 NE Practitioner - Gastroenterology 8628341831 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Nebraska College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastroenterology Specialties PCGroup PAC ID 5991696775, 51 clinicians

Practice addresses (Care Compare)

3901 Pine Lake Rd
Suite 211
Lincoln, NE 68516-5497
Phone (402) 465-4545

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy92
Upper gastrointestinal (GI) endoscopy for acid reflux126

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gastroenterology Specialties, P.C. CurrentSince Jul 13, 2023 Accepting new patients
Lincoln Digestive Health Center LLC PastSince Jul 13, 2023 Accepting new patients

Locations

3901 Pine Lake Rd
Ste 211
Lincoln, NE 68516
Phone (402) 423-4200

4545 R St
Lincoln, NE 68503
Phone (402) 465-4545

4545 R St
Ste 100
Lincoln, NE 68503
Phone (402) 465-4545

Interoperability endpoints

  • FHIR API: https://498f20c3-8d5e-4c38-b37b-2e5c29e690f9.gastro.prod.fhir.ema-api.com/fhir/r4/
  • Direct secure messaging: sknooihuizen110478@direct.phhs.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1164943171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4545 R ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685033799",
            "telephone_number": "402-465-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 R ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685033799",
            "telephone_number": "402-465-4545",
            "fax_number": "402-465-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOOIHUIZEN",
        "first_name": "SALLY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-29",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NE",
            "license": "35811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.