NPIMap

Organization Active NPI

Surgical Associates, P.C.

  • Surgery Physician
  • Lincoln, NE
National Provider Identifier
1801831268
Registry record updated Feb 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
SURGICAL ASSOCIATES, P.C.
Practice address
1001 S 70TH St Ste 100
Lincoln, NE 68510-7901
Phone
(402) 441-4760
Fax
(402) 441-4764
NPI assigned
Jun 19, 2006
Last updated
Feb 12, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2019

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

Authorized official

Name
Mr. Joel Mason Gustafson
Title
Administrator
Phone
(402) 441-4760

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary
Obesity Medicine (Internal Medicine) Physician 207RB0002X NU

Addresses

Primary practice location

1001 S 70TH St Ste 100
Lincoln, NE 68510-7901

Mailing address

1001 S 70TH St Ste 100
Lincoln, NE 68510-7901
Phone (402) 441-4760

Other practice location 1

575 S 70th St
Suite 310
Lincoln, NE 68510-2471
Phone (402) 441-4760

Other identifiers 3

IdentifierTypeStateIssuer
10025389300MedicaidNE
200385800AMedicaidKS
30119OtherNEBCBS GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060727000259 NE Part B Supplier - Clinic/Group Practice 8921011529 Receives reassigned benefits from 17 practitioners
Practice locations: Lincoln, NE

National Provider Directory

National Provider Directory

Locations

1001 S 70th St
Ste 100
Lincoln, NE 68510
Phone (402) 423-0762

Interoperability endpoints

  • Direct secure messaging: anthonytabatabai@sapc.allscriptsdirect.net
  • Direct secure messaging: austinhenslee@sapc.allscriptsdirect.net
  • Direct secure messaging: benjaminhung@sapc.allscriptsdirect.net
  • Direct secure messaging: dianazapp@sapc.allscriptsdirect.net
  • Direct secure messaging: gregfitzke@sapc.allscriptsdirect.net
  • Direct secure messaging: jamesmarkman@sapc.allscriptsdirect.net
  • Direct secure messaging: jessicaharper@sapc.allscriptsdirect.net
  • Direct secure messaging: katieviarush-wilks@sapc.allscriptsdirect.net
  • Direct secure messaging: kellyjohnsonkrier@sapc.allscriptsdirect.net
  • Direct secure messaging: maggiegoltz@sapc.allscriptsdirect.net
  • Direct secure messaging: maudinest.onge@sapc.allscriptsdirect.net
  • Direct secure messaging: oliverknoell@sapc.allscriptsdirect.net
  • Direct secure messaging: oscarlucar@sapc.allscriptsdirect.net
  • Direct secure messaging: quyhaiha@sapc.allscriptsdirect.net

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549929600000",
    "number": "1801831268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 S 70TH ST STE 100",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685107901",
            "telephone_number": "402-441-4760",
            "fax_number": "402-441-4764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S 70TH ST STE 100",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685107901",
            "telephone_number": "402-441-4760",
            "fax_number": "402-441-4764"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "575 S 70th St",
            "address_2": "Suite 310",
            "address_purpose": "LOCATION",
            "city": "Lincoln",
            "state": "NE",
            "postal_code": "685102471",
            "country_code": "US",
            "telephone_number": "402-441-4760",
            "fax_number": "402-441-4764",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SURGICAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2019-02-12",
        "status": "A",
        "authorized_official_last_name": "GUSTAFSON",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "MASON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "402-441-4760",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RB0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Obesity Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025389300",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200385800A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "30119",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.