Makenzie Lahm, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

13616 California St Ste 100
Omaha, NE 68154-5336

Phone

(402) 496-5517

NPI assigned

Jun 1, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Nebraska Spine Center, LLP

  • Orthopaedic Surgery of the Spine Physician
  • Omaha, NE
  • NPI 1588667950
  Medicare reassignment

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

{
    "created_epoch": "1590969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1336763879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13616 CALIFORNIA ST STE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681545336",
            "telephone_number": "402-496-5517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13616 CALIFORNIA ST STE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681545336",
            "telephone_number": "402-496-5517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAHM",
        "first_name": "MAKENZIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-01",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47081304012",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lah Lah
• Sher Lah
• Wah Lah
• Beverly Lahlum Taylor
• Derek W Lahm, MD
• Dustin Lahman, DPT
• Janem Lahpai
• Aye Lai
• Khanh Phuong Lai, SOCIAL WORKER
• Nicholas Laidlaw

• Surgical Physician Assistant in Omaha, NE
• Providers in Omaha, NE by specialty
• Surgical Physician Assistant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.