NPIMap

Organization Active NPI

Lighthouse Anesthesia PC

  • Anesthesiology Physician
  • Lincoln, NE
National Provider Identifier
1285237750
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
LIGHTHOUSE ANESTHESIA PC
Practice address
1730 S 70TH St
Lincoln, NE 68506-1613
Phone
(402) 423-7774
Fax
(402) 261-5185
NPI assigned
Nov 18, 2020
Last updated
Jan 10, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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

Authorized official

Name
Ricky Gene Hartwig, MDNPI 1083720866
Title
President, Owner
Phone
(402) 423-7774

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X Primary

Addresses

Primary practice location

1730 S 70TH St
Lincoln, NE 68506-1613

Mailing address

PO Box 67099
Lincoln, NE 68506-7099
Phone (402) 423-7774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201221001603 NE Part B Supplier - Clinic/Group Practice 4789096595 Receives reassigned benefits from 17 practitioners
Practice locations: Lincoln, NE

National Provider Directory

National Provider Directory

Locations

1730 S 70th St
Lincoln, NE 68506
Phone (402) 423-7774

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641772800000",
    "number": "1285237750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67099",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685067099",
            "telephone_number": "402-423-7774",
            "fax_number": "402-261-5185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 S 70TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685061613",
            "telephone_number": "402-423-7774",
            "fax_number": "402-261-5185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE ANESTHESIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-18",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A",
        "authorized_official_last_name": "HARTWIG",
        "authorized_official_first_name": "RICKY",
        "authorized_official_middle_name": "GENE",
        "authorized_official_title_or_position": "PRESIDENT, OWNER",
        "authorized_official_telephone_number": "402-423-7774",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.