Individual provider Active NPI

Sean L Hansen, MD

  • Family Medicine Physician
  • Lincoln, NE
National Provider Identifier
1699973164
Registry record updated Jan 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
TEP5575 Issued in NE
Practice address
4600 Valley Road
Suite 200
Lincoln, NE 68510-4844
Phone
(402) 483-4571
Fax
(402) 483-5079
NPI assigned
Jul 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X TEP5575 NE Primary

Addresses

Primary practice location

4600 Valley Road
Suite 200
Lincoln, NE 68510-4844

Mailing address

555 S 70TH St
Lincoln, NE 68510-2462
Phone (402) 483-4571

Other identifiers 1

IdentifierTypeStateIssuer
47055301100MedicaidNE

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100817000945 NE Practitioner - HospitalistPractitioner - Family Practice 9638211808 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CHI Health Clinic Specialty LLCGroup PAC ID 4789098443, 317 clinicians

Practice addresses (Care Compare)

555 S 70TH St
St Elizabeth Regional Med Center
Lincoln, NE 68510-2462
Phone (402) 219-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TEP5575NEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CHI Health Clinic Specialty, LLC Family Medicine CurrentSince Jan 1, 2021 Accepting new patients
Saint Elizabeth Regional Medical Center Past Accepting new patients

Locations

555 S 70th St
Lincoln, NE 68510
Phone (402) 219-8000

8207 Northwoods Dr
Ste 100
Lincoln, NE 68505
Phone (402) 484-3440

Organizations & group practices 2

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": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611964800000",
    "number": "1699973164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 S 70TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102462",
            "telephone_number": "402-483-4571",
            "fax_number": "402-483-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 VALLEY ROAD",
            "address_2": "SUITE 200",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685104844",
            "telephone_number": "402-483-4571",
            "fax_number": "402-483-5079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "SEAN",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-06",
        "last_updated": "2021-01-30",
        "certification_date": "2021-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "TEP5575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47055301100",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.