Individual provider Active NPI

Stacy Ann Lewandowski, PA-C

  • Medical Physician Assistant
  • Beatrice, NE
National Provider Identifier
1376639120
Registry record updated Nov 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
948 Issued in NE
Practice address
805 W Court St
Beatrice, NE 68310-3525
Phone
(402) 228-3366
Fax
(402) 228-3502
NPI assigned
Oct 5, 2006
Last updated
Nov 17, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 948 NE Primary

Addresses

Primary practice location

805 W Court St
Beatrice, NE 68310-3525

Mailing address

805 W Court St
Beatrice, NE 68310-3525
Phone (402) 228-3366

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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060220000288 NE Practitioner - Physician Assistant 8527073030 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

PO Box
Suite 278
Beatrice, NE 68310-0278

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
948NEMDOccupational Therapy Assistant

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447718400000",
    "number": "1376639120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 W COURT ST",
            "city": "BEATRICE",
            "state": "NE",
            "postal_code": "683103525",
            "telephone_number": "402-228-3366",
            "fax_number": "402-228-3502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 W COURT ST",
            "city": "BEATRICE",
            "state": "NE",
            "postal_code": "683103525",
            "telephone_number": "402-228-3366",
            "fax_number": "402-228-3502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWANDOWSKI",
        "first_name": "STACY",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2015-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beatrice, NE

Sources for this page

Verify at the official NPI Registry.