Individual provider Active NPI

Lena Lilia Mininberg, MSN

  • Women's Health Nurse Practitioner
  • Omaha, NE
National Provider Identifier
1215676309
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
12453 Issued in MN
Practice address
4910 S 30TH St FL 1
Omaha, NE 68107-1519
Phone
(402) 502-8859
NPI assigned
May 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 12453 MN Primary
Advanced Practice Midwife 367A00000X

Addresses

Primary practice location

4910 S 30TH St FL 1
Omaha, NE 68107-1519

Mailing address

60 Hyslop Rd
Brookline, MA 02445-5725
Phone (617) 365-9977

Other practice location 1

671 Vandalia St
Saint Paul, MN 55114-1312
Phone (800) 230-7526

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, MN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221012003335 NE Practitioner - Certified Nurse Midwife (CNM) 5193191385 Reassigns benefits to 1 organization
I20250530001129 MN Practitioner - Nurse Practitioner 5193191385 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Yale University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Planned Parenthood MN, ND, SDGroup PAC ID 6002709631, 27 clinicians

Practice addresses (Care Compare)

671 Vandalia St
Saint Paul, MN 55114-1312
Phone (651) 698-2406

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

Practice roles

OrganizationSpecialtyStatusNew patients
Oneworld Community Health Centers, Inc. CurrentSince Aug 1, 2022 Accepting new patients
Oneworld Community Health Centers, Inc. CurrentSince Aug 1, 2022 Accepting new patients
Planned Parenthood Minnesota, North Dakota, South Dakota CurrentSince May 20, 2025 Accepting new patients
Alegent Health Bergan Mercy Health System Past Accepting new patients

Locations

671 Vandalia St
Saint Paul, MN 55114
Phone (651) 696-5674

4920 S 30th St
Ste 103
Omaha, NE 68107

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1653609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1215676309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 HYSLOP RD",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024455725",
            "telephone_number": "617-365-9977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4910 S 30TH ST FL 1",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681071519",
            "telephone_number": "402-502-8859"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "671 Vandalia St",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551141312",
            "country_code": "US",
            "telephone_number": "800-230-7526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MININBERG",
        "first_name": "LENA",
        "middle_name": "LILIA",
        "credential": "MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-27",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MN",
            "license": "12453",
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.