Individual provider Active NPI

Duane E Polzien, OD

  • Optometrist
  • Lincoln, NE
National Provider Identifier
1174614200
Registry record updated Jun 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
757 Issued in NE
Practice address
6900 O Street
#127
Lincoln, NE 68510-2460
Phone
(402) 466-4111
Fax
(402) 466-4202
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 757 NE Primary

Addresses

Primary practice location

6900 O Street
#127
Lincoln, NE 68510-2460

Mailing address

6900 O Street
#127
Lincoln, NE 68510-2460
Phone (402) 466-4111

Other identifiers 2

IdentifierTypeStateIssuer
47080172500MedicaidNE
100025846400MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275609600000",
    "number": "1174614200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 O STREET",
            "address_2": "#127",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102460",
            "telephone_number": "402-466-4111",
            "fax_number": "402-466-4202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 O STREET",
            "address_2": "#127",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102460",
            "telephone_number": "402-466-4111",
            "fax_number": "402-466-4202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLZIEN",
        "first_name": "DUANE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2010-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47080172500",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100025846400",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.