Individual provider Active NPI

Randall Scott Lienemann, PHYSICIAN ASST PA C

  • Physician Assistant
  • Omaha, NE
National Provider Identifier
1629025879
Registry record updated Apr 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
638 Issued in NE
Practice address
987400 Nebraska Medical Ctr
Omaha, NE 68198-1799
Phone
(402) 559-6637
Fax
(402) 559-8333
NPI assigned
May 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 638 NE
Physician Assistant 363A00000X 638 NE Primary

Addresses

Primary practice location

987400 Nebraska Medical Ctr
Omaha, NE 68198-1799

Mailing address

988102 Nebraska Medical Ctr
Omaha, NE 68198-8102

Other identifiers 1

IdentifierTypeStateIssuer
P00165113OtherRR MCR

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
I20060222000703 NE Practitioner - Physician Assistant 2860408200 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unmc PhysiciansGroup PAC ID 6002728391, 1,490 clinicians

Practice addresses (Care Compare)

2510 Bellevue Medical Ctr Dr
Bellevue, NE 68123-1520

5005 Ames Ave
Omaha, NE 68104-2323
Phone (402) 559-0282

8343 S 168TH Ave
Unmc Physicians Chalco
Omaha, NE 68136-1677
Phone (402) 559-0444

Emile 42ND St
Omaha, NE 68198-0001
Phone (402) 559-4015

Hospital & facility affiliations

  • The Nebraska Medical Center Hospital, Omaha, NE, CCN 280013
  • Bellevue Medical Center Hospital, Bellevue, NE, CCN 280132

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
638NEMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Physicians Past Accepting new patients
Nebraska Orthopaedic Hospital LLC Past Accepting new patients
Bott PC Past Accepting new patients

Organizations & group practices 4

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 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": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523836800000",
    "number": "1629025879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988102 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681988102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "987400 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681981799",
            "telephone_number": "402-559-6637",
            "fax_number": "402-559-8333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIENEMANN",
        "first_name": "RANDALL",
        "middle_name": "SCOTT",
        "credential": "PHYSICIAN ASST PA C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2018-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "638",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "P00165113",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.