Active NPI
Lisa M Pietig, PA-C
- Physician Assistant
- Lincoln, NE
National Provider Identifier
1588902605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1701
- Practice address
- 575 S 70TH St
Suite 200
Lincoln, NE 68510-2471 - Phone
- (402) 488-3322
- Fax
- (402) 488-1172
- NPI assigned
- Jan 24, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1701 | NE | Primary |
Addresses
Primary practice location
575 S 70TH St
Suite 200
Lincoln, NE 68510-2471
Mailing address
575 S 70TH St
Suite 200
Lincoln, NE 68510-2471
Phone (402) 488-3322
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 470703099-13 | Medicaid | NE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1701 | NE | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nebraska Orthopaedic Center PC | Past | Accepting new patients |
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 and National Provider Directory roles.
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- Lincoln, NE
- NPI 1659349330
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1358985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483920000000",
"number": "1588902605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "575 S 70TH ST",
"address_2": "SUITE 200",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685102471",
"telephone_number": "402-488-3322",
"fax_number": "402-488-1172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "575 S 70TH ST",
"address_2": "SUITE 200",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685102471",
"telephone_number": "402-488-3322",
"fax_number": "402-488-1172"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PIETIG",
"first_name": "LISA",
"middle_name": "M",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-24",
"last_updated": "2017-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NE",
"license": "1701",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "470703099-13",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.