Individual provider Active NPI

Sandra Lloyd, P.A.C.

  • Physician Assistant
  • Lincoln, NE
National Provider Identifier
1285684647
Registry record updated Jun 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
575 Issued in NE
Practice address
4333 S 86TH St
Lincoln, NE 68526-9260
Phone
(402) 483-8500
Fax
(402) 483-8500
NPI assigned
May 10, 2006
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2222 S 16TH St
Suite 400a
Lincoln, NE 68502-3785

Hospital & facility affiliations

  • Bryan Medical Center Hospital, Lincoln, NE, CCN 280003

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: No
Green means eligible to order or refer.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20041014000157 NE Practitioner - Physician Assistant 5193785194 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
575NEMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Lincoln Physician Network LLC Past Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 575 NE Primary

Addresses

NPPES NPI Registry

Primary practice location

4333 S 86TH St
Lincoln, NE 68526-9260

Mailing address

4333 S 86TH St
Lincoln, NE 68526-9260
Phone (402) 483-8500

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
10025250200MedicaidNE

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 23, 2023.

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1285684647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4333 S 86TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685269260",
            "telephone_number": "402-483-8500",
            "fax_number": "402-483-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4333 S 86TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685269260",
            "telephone_number": "402-483-8500",
            "fax_number": "402-483-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LLOYD",
        "first_name": "SANDRA",
        "credential": "P.A.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025250200",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.