Individual provider Active NPI

Lawrence Danczak, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Omaha, NE
National Provider Identifier
1760159636
Registry record updated May 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
113587 Issued in NE
Practice address
415 S 25TH Ave
Omaha, NE 68131-3630
Phone
(402) 717-5550
NPI assigned
Aug 26, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 113587 NE Primary

Addresses

Primary practice location

415 S 25TH Ave
Omaha, NE 68131-3630

Mailing address

415 S 25TH Ave
Omaha, NE 68131-3630
Phone (402) 717-5550

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lawrence.danczak@commonspirit.org Direct

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
I20220111001049 NE Practitioner - Nurse Practitioner 5193117786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton HealthGroup PAC ID 1850285255, 137 clinicians

Practice addresses (Care Compare)

2001 S 75TH St
Omaha, NE 68124-2475
Phone (402) 398-5550

Hospital & facility affiliations

  • CHI Health Mercy Council Bluffs Hospital, Council Bluffs, IA, CCN 160028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
113587NEMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Health CurrentSince Jan 18, 2022 Accepting new patients
Alegent Creighton Health CurrentSince Jan 18, 2022 Accepting new patients

Locations

2771 Solution Ctr
Chicago, IL 60677

2001 S 75th St
Omaha, NE 68124
Phone (402) 398-5550

7261 Mercy Rd
Omaha, NE 68124
Phone (402) 398-6248

7101 Newport Ave
Omaha, NE 68152
Phone (402) 572-2905

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 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": "1629936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715990400000",
    "number": "1760159636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 25TH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681313630",
            "telephone_number": "402-717-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S 25TH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681313630",
            "telephone_number": "402-717-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANCZAK",
        "first_name": "LAWRENCE",
        "credential": "APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-26",
        "last_updated": "2024-05-18",
        "certification_date": "2024-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NE",
            "license": "113587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lawrence.danczak@commonspirit.org",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "work email",
            "address_1": "415 S 25th Ave",
            "city": "Omaha",
            "state": "NE",
            "country_code": "US",
            "postal_code": "681313630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.