NPIMap

Individual provider Active NPI

Kendra Elizabeth Luebke

  • Otolaryngology Physician
  • Omaha, NE
National Provider Identifier
1669714275
Registry record updated Apr 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
30801 Issued in NE
Practice address
720 N 129TH St
Omaha, NE 68154-6109
Phone
(402) 397-0670
NPI assigned
Mar 21, 2013
Last updated
Apr 10, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 30801 NE Primary

Addresses

Primary practice location

720 N 129TH St
Omaha, NE 68154-6109

Mailing address

720 N 129TH St
Omaha, NE 68154-6109
Phone (402) 397-0670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20181030000128 NE Practitioner - Otolaryngology 9830489665 Reassigns benefits to 7 organizations
I20181127001529 IA Practitioner - Otolaryngology 9830489665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Nebraska College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT Specialists PCGroup PAC ID 3173517539, 11 clinicians

Practice addresses (Care Compare)

720 N 129TH St
Omaha, NE 68154-6109
Phone (402) 397-0670

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Saunders Medical Center CurrentSince Aug 26, 2020 Accepting new patients
ENT Specialists PC Otolaryngology CurrentSince Sep 17, 2018 Accepting new patients
Brodstone Memorial Hospital CurrentSince Oct 1, 2020 Accepting new patients
Memorial Community Hospital Corporation CurrentSince Apr 1, 2023 Accepting new patients
Brodstone Memorial Hospital Current Accepting new patients
Memorial Community Hospital Corporation CurrentSince Apr 1, 2023 Accepting new patients
Saunders Medical Center CurrentSince Aug 26, 2020 Accepting new patients
Saunders Medical Center Current Accepting new patients
Brodstone Memorial Hospital CurrentSince Oct 1, 2020 Accepting new patients
Saunders Medical Center Past Accepting new patients

Locations

933 E Pierce St
Council Bluffs, IA 51503
Phone (712) 328-6000

810 N 22nd St
Blair, NE 68008
Phone (402) 426-1116

812 N 22nd St
Blair, NE 68008
Phone (402) 426-4611

720 N 129th St
Omaha, NE 68154
Phone (402) 397-0670

520 E 10th St
Superior, NE 68978
Phone (402) 224-3344

1760 County Road J
Wahoo, NE 68066
Phone (402) 443-4191

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/06e9d567-9657-447f-97fb-d967654387e7/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1363824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554854400000",
    "number": "1669714275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 N 129TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681546109",
            "telephone_number": "402-397-0670",
            "fax_number": "402-397-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 N 129TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681546109",
            "telephone_number": "402-397-0670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUEBKE",
        "first_name": "KENDRA",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-21",
        "last_updated": "2019-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NE",
            "license": "30801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.