Urology Surgical Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

ASC028 Issued in NE

Legal business name

UROLOGY SURGICAL CENTER LLC

Practice address

5500 Pine Lake Rd
Lincoln, NE 68516-3389

Phone

(402) 421-8899

Fax

(402) 421-8950

NPI assigned

Jun 3, 2006

Last updated

Feb 10, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jenna Stratman

Title

Administrator

Phone

(402) 489-8888

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Listed as

Urology Surgical Center LLCCCN 28C0001022

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 7

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.

• Thomas P Brush, M.D.

  • Urology Physician
  • Lincoln, NE
  • NPI 1669889200
  NPD
• Tara Michele Kirkpatrick, MD

  • Urology Physician
  • Lincoln, NE
  • NPI 1518227958
  NPD
• Aaron James Pomajzl, M.D.

  • Urology Physician
  • Lincoln, NE
  • NPI 1932550084
  NPD
• Amy Kathryn Collingham, APRN

  • Family Nurse Practitioner
  • Lincoln, NE
  • NPI 1215679303
  NPD (past)
• Jacob L Creevan, PA-C

  • Physician Assistant
  • Lincoln, NE
  • NPI 1073247748
  NPD (past)
• David Brian Wiltfong, MD

  • Urology Physician
  • Lincoln, NE
  • NPI 1467475731
  NPD (past)
• Katherine Malinda Wolverton, APRN

  • Family Nurse Practitioner
  • Lincoln, NE
  • NPI 1033851282
  NPD (past)

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612915200000",
    "number": "1467490433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 PINE LAKE RD",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685163389",
            "telephone_number": "402-421-8899",
            "fax_number": "402-421-8950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 PINE LAKE RD",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685163389",
            "telephone_number": "402-421-8899",
            "fax_number": "402-421-8950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UROLOGY SURGICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A",
        "authorized_official_last_name": "STRATMAN",
        "authorized_official_first_name": "JENNA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "402-489-8888"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NE",
            "license": "ASC028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "F1023",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUE SHIELD PPO",
            "identifier": "01082",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "6800029",
            "state": "NE"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "surgical.urology.p1@direct.upc.nextgenshare.com",
            "affiliation": "N",
            "address_1": "5500 Pine Lake Rd",
            "city": "Lincoln",
            "state": "NE",
            "country_code": "US",
            "postal_code": "685163389",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stefanie Lynn Urbom, PT
• Urgent Care Clinic of Lincoln, P.C.
• Urgent Care Clinic of Lincoln, PC
• Randall Jon Uribe, PLADC
• Cristina A Uriostegui
• Shelby Urtel
• Brandi Nicole Urwiler-Settje, M.A., LIMHP
• Lisa Urwiller
• Oleksandr Ushakov
• Diane Usher

• Ambulatory Surgical Clinic/Center in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Ambulatory Surgical Clinic/Center in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.