NPIMap

Individual provider Active NPI

Lisa M Koziol, APRN

  • Family Nurse Practitioner
  • Omaha, NE
National Provider Identifier
1467401760
Registry record updated Apr 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
110676 Issued in NE
Practice address
17021 Lakeside Hills PLZ
Suite 100
Omaha, NE 68130-2390
Phone
(402) 333-0300
Fax
(402) 333-0302
NPI assigned
May 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 110676 NE Primary

Addresses

Primary practice location

17021 Lakeside Hills PLZ
Suite 100
Omaha, NE 68130-2390

Mailing address

17021 Lakeside Hills PLZ
Suite 100
Omaha, NE 68130-2390
Phone (402) 333-0300

Other identifiers 2

IdentifierTypeStateIssuer
37875OtherNEBCBS
47083454608MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050107000892 NE Practitioner - Nurse Practitioner 3173571965 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Nebraska College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Clinic IncGroup PAC ID 4880506062, 557 clinicians

Practice addresses (Care Compare)

11946 Standing Stone Dr
Gretna, NE 68028-8094
Phone (402) 815-4500

Hospital & facility affiliations

  • The Nebraska Methodist Hospital Hospital, Omaha, NE, CCN 280040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Clinic Inc CurrentSince Aug 31, 2021 Accepting new patients
Nebraska Methodist Hospital Current Accepting new patients
Unmc Physicians CurrentSince Jan 24, 2020 Accepting new patients
Alegent Creighton Clinic Past Accepting new patients
Pedxm, PC Past Accepting new patients
Alegent Health Quick Care LLC Past Accepting new patients

Locations

11946 Standing Stone Dr
Gretna, NE 68028
Phone (402) 815-4500

Emile 42nd St
Omaha, NE 68198
Phone (402) 552-6731

825 S 169th St
Fl 3
Omaha, NE 68118
Phone (402) 354-5451

10060 Regency Cir
Omaha, NE 68114
Phone (402) 354-1405

Emile At 42nd St
Omaha, NE 68198
Phone (402) 559-8888

Interoperability endpoints

  • Direct secure messaging: lisa.koziol@direct.nmhs.org
  • Direct secure messaging: lisa.koziol.1@17404.direct.athenahealth.com

Organizations & group practices 10

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 1

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": "1146873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429142400000",
    "number": "1467401760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17021 LAKESIDE HILLS PLZ",
            "address_2": "SUITE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681302390",
            "telephone_number": "402-333-0300",
            "fax_number": "402-333-0302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17021 LAKESIDE HILLS PLZ",
            "address_2": "SUITE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681302390",
            "telephone_number": "402-333-0300",
            "fax_number": "402-333-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZIOL",
        "first_name": "LISA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-06",
        "last_updated": "2015-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "110676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "37875",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47083454608",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.