Individual provider Active NPI

Alisha Nicole Lautenschlager, PA-C

  • Physician Assistant
  • Grand Island, NE
National Provider Identifier
1790933711
Registry record updated May 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1402 Issued in NE
Practice address
418 N Webb Rd
Grand Island, NE 68803-4045
Phone
(308) 384-9300
Fax
(308) 384-4552
NPI assigned
Sep 3, 2008
Last updated
May 31, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1402 NE Primary

Addresses

Primary practice location

418 N Webb Rd
Grand Island, NE 68803-4045

Mailing address

418 N Webb Rd
Grand Island, NE 68803-4045
Phone (308) 384-9300

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
I20081016000259 NE Practitioner - Physician Assistant 1951469154 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians
Advanced Dermatology and Skin Cancer Center PAGroup PAC ID 1557304672, 5 clinicians

Practice addresses (Care Compare)

16909 Lakeside Hills CT
Omaha, NE 68130-4661

211 W 33Rd St
Kearney, NE 68845-3484
Phone (308) 865-2141

2530 Sheridan Ave
Grand Island, NE 68803-1903
Phone (308) 398-5522

2908 W 39TH St
Suite D
Kearney, NE 68845-1245
Phone (308) 270-1100

820 N Webb Rd
Suite 104
Grand Island, NE 68803-3325
Phone (308) 384-0133

908 N Howard Ave
109 CHI Health Clinic
Grand Island, NE 68803-3529
Phone (308) 398-5522

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1402NEMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic Physician Assistant Past Accepting new patients

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": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496188800000",
    "number": "1790933711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 N WEBB RD",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034045",
            "telephone_number": "308-384-9300",
            "fax_number": "308-384-4542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 N WEBB RD",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034045",
            "telephone_number": "308-384-9300",
            "fax_number": "308-384-4552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUTENSCHLAGER",
        "first_name": "ALISHA",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-03",
        "last_updated": "2017-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

Verify at the official NPI Registry.