Individual provider Active NPI

Kendra Lesiak

  • MOHS-Micrographic Surgery Physician
  • Omaha, NE
National Provider Identifier
1699074096
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
29348 Issued in NE
Practice address
909 N 96TH St.
Suite 201
Omaha, NE 68114-2508
Phone
(402) 330-4555
Fax
(402) 330-4626
NPI assigned
Mar 24, 2011
Last updated
Nov 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X 29348 NE Primary
Dermatology Physician 207N00000X 29348 NE

Addresses

Primary practice location

909 N 96TH St.
Suite 201
Omaha, NE 68114-2508

Mailing address

909 N 96TH St.
Suite 201
Omaha, NE 68114-2508
Phone (402) 330-4555

Other names 1

  • Kendra Simpson Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160819001143 NE Practitioner - Dermatology 2961797675 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Nebraska College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians
Dermatology Specialists of Omaha LLCGroup PAC ID 7113018581, 13 clinicians

Practice addresses (Care Compare)

909 N 96TH St
Dermatology Specialists of Omaha
Omaha, NE 68114-2497
Phone (402) 330-4555

909 N 96TH St
Suite 201
Omaha, NE 68114-2508
Phone (402) 330-4555

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.86 of 100Reported as group
Quality
46
Improvement activities
40
Cost
91.54

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision176
Removal of skin lesions53
Removal of skin cancer763
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy37

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29348NEMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Forefront Dermatology, S.C. Dermatology CurrentSince Dec 2, 2025 Accepting new patients
Forefront Dermatology, S.C. Dermatology CurrentSince Dec 2, 2025 Accepting new patients
Dermatology Specialists of Omaha LLC Dermatology CurrentSince Sep 6, 2016 Accepting new patients

Locations

1825 N 205th St
Elkhorn, NE 68022
Phone (402) 330-4555

909 N 96th St
Omaha, NE 68114
Phone (402) 330-4555

909 N 96th St
Ste 201
Omaha, NE 68114
Phone (402) 330-4555

Interoperability endpoints

  • Direct secure messaging: kendralesiak@dsollc.allscriptsdirect.net

Organizations & group practices 3

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 1

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": "1300924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762992000000",
    "number": "1699074096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 N 96TH ST.",
            "address_2": "SUITE 201",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681142508",
            "telephone_number": "402-330-4555",
            "fax_number": "402-330-4626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 N 96TH ST.",
            "address_2": "SUITE 201",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681142508",
            "telephone_number": "402-330-4555",
            "fax_number": "402-330-4626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESIAK",
        "first_name": "KENDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-24",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NE",
            "license": "29348",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NE",
            "license": "29348",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENDRA",
            "last_name": "SIMPSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.