Individual provider Active NPI

Lesley K Klug, APRN

  • Nurse Practitioner
  • Omaha, NE
National Provider Identifier
1760561328
Registry record updated Feb 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
111976 Issued in NE
Practice address
17201 Wright St Ste 200
Omaha, NE 68130-2042
Phone
(402) 334-4773
Fax
(402) 334-7463
NPI assigned
Nov 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X NP8436 CA
Nurse Practitioner 363L00000X 111976 NE Primary

Addresses

Primary practice location

17201 Wright St Ste 200
Omaha, NE 68130-2042

Mailing address

PO Box 241573
Omaha, NE 68124-2346
Phone (402) 393-3110

Other identifiers 1

IdentifierTypeStateIssuer
454770OtherCAREGISTERED NURSE

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
I20180220001618 NE Practitioner - Nurse Practitioner 2769656552 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oncology Hematology West PCGroup PAC ID 8426030024, 56 clinicians

Practice addresses (Care Compare)

17201 Wright St
Suite 200
Omaha, NE 68130-2042
Phone (402) 334-4773

Merit-based Incentive Payment System (MIPS)

Final score
85.11 of 100Reported as group
Quality
89.93
Promoting interoperability
100
Improvement activities
40
Cost
54.41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP8436CAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oncology Hematology West, PC CurrentSince Jan 16, 2018 Accepting new patients
Oncology Hematology West, PC CurrentSince Jan 16, 2018 Accepting new patients

Locations

450 E 23rd St
Fremont, NE 68025
Phone (402) 721-1610

8303 Dodge St
Ste 250
Omaha, NE 68114
Phone (402) 354-8124

7500 Mercy Rd
#1300
Omaha, NE 68124
Phone (402) 393-3110

7500 Mercy Rd
Ste 1300
Omaha, NE 68124
Phone (402) 334-4773

17201 Wright St
Ste 200
Omaha, NE 68130
Phone (402) 334-4773

611 Fenwick Dr
Papillion, NE 68046
Phone (402) 593-3141

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.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519257600000",
    "number": "1760561328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 241573",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242346",
            "telephone_number": "402-393-3110",
            "fax_number": "402-398-4499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17201 WRIGHT ST STE 200",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681302042",
            "telephone_number": "402-334-4773",
            "fax_number": "402-334-7463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUG",
        "first_name": "LESLEY",
        "middle_name": "K",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2018-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "NP8436",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NE",
            "license": "111976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "454770",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.