NPIMap

Organization Active NPI

Prairie Orthopaedic & Plastic Surgery, P.C.

  • Orthopaedic Surgery Physician
  • Lincoln, NE
National Provider Identifier
1639206147
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
19446 Issued in NE
Legal business name
PRAIRIE ORTHOPAEDIC & PLASTIC SURGERY, P.C.
Practice address
4130 Pioneer Woods Dr
Suite 1
Lincoln, NE 68506-7551
Phone
(402) 489-4700
NPI assigned
Feb 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Authorized official

Name
Dr. Patrick T Hurlbut, MDNPI 1225060015
Title
Physician-Owner
Phone
(402) 489-4700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X 19446 NE Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 1739 NE
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

4130 Pioneer Woods Dr
Suite 1
Lincoln, NE 68506-7551

Mailing address

4130 Pioneer Woods Dr Ste 1
Lincoln, NE 68506-7552
Phone (402) 489-4700

Other practice location 1

3901 W Norfolk Ave
Norfolk, NE 68701-4405
Phone (402) 489-4700

Other practice location 2

5901 N 28th St
Lincoln, NE 68504-9820
Phone (402) 489-4700

Other identifiers 3

IdentifierTypeStateIssuer
10025490400MedicaidNE
DG0311OtherRRM
612249600OtherDOL/ACS WORKERS COMP

Other names 1

  • Prairie Shoulder Elbow & Hand Center Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070323000153 NE Part B Supplier - Clinic/Group Practice 0345344818 Receives reassigned benefits from 25 practitioners
Practice locations: Lincoln, NE
O20150401000533 NE DME Supplier - Multi-Specialty - Physician 0345344818 Practice locations: Lincoln, NE

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

4130 Pioneer Woods Dr
Ste 1
Lincoln, NE 68506
Phone (402) 489-4700

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660867200000",
    "number": "1639206147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4130 PIONEER WOODS DR STE 1",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685067552",
            "telephone_number": "402-489-4700",
            "fax_number": "402-489-5220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 PIONEER WOODS DR",
            "address_2": "SUITE 1",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685067551",
            "telephone_number": "402-489-4700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3901 W Norfolk Ave",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "NE",
            "postal_code": "687014405",
            "country_code": "US",
            "telephone_number": "402-489-4700",
            "fax_number": "402-489-5220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5901 N 28th St",
            "address_purpose": "LOCATION",
            "city": "Lincoln",
            "state": "NE",
            "postal_code": "685049820",
            "country_code": "US",
            "telephone_number": "402-489-4700",
            "fax_number": "402-489-5220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRAIRIE ORTHOPAEDIC & PLASTIC SURGERY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A",
        "authorized_official_last_name": "HURLBUT",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PHYSICIAN-OWNER",
        "authorized_official_telephone_number": "402-489-4700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "NE",
            "license": "19446",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "1739",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025490400",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRM",
            "identifier": "DG0311",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOL/ACS WORKERS COMP",
            "identifier": "612249600",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prairie Shoulder Elbow & Hand Center",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Prairie Shoulder Elbow & Hand Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Aug 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.