Individual provider Active NPI

Suzan S Pae, M.D.

  • Allergy & Immunology Physician
  • Lincoln, NE
National Provider Identifier
1811977580
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
32635 Issued in NE
Practice address
600 N Cotner Blvd Ste 208
Lincoln, NE 68505-2343
Phone
(402) 464-5969
Fax
(402) 464-3657
NPI assigned
Jan 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 32635 NE Primary

Addresses

Primary practice location

600 N Cotner Blvd Ste 208
Lincoln, NE 68505-2343

Mailing address

600 N Cotner Blvd Ste 208
Lincoln, NE 68505-2343
Phone (402) 464-5969

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200811000399 NE Practitioner - Internal MedicinePractitioner - Allergy/Immunology 5890723233 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Allergy/Immunology
Education
University of Nebraska College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allergy Asthma and Immunology Associates PCGroup PAC ID 4385610013, 15 clinicians

Practice addresses (Care Compare)

600 N Cotner Blvd
Suite 208
Lincoln, NE 68505-2343
Phone (402) 464-5969

Hospital & facility affiliations

  • Bryan Medical Center Hospital, Lincoln, NE, CCN 280003
  • Mary Lanning Healthcare Hospital, Hastings, NE, CCN 280032

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32635NEMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy, Asthma & Immunology Associates P.C. Allergy & Immunology CurrentSince Oct 1, 2020 Accepting new patients
Allergy, Asthma & Immunology Associates, P.C. Allergy & Immunology Current Accepting new patients

Locations

723 W Fairview St
Albion, NE 68620
Phone (402) 385-3149

638 N Webb Rd
Grand Island, NE 68803
Phone (308) 675-3171

315 W 11th St
Kearney, NE 68845
Phone (308) 234-9339

3901 Pine Lake Rd
Ste 405
Lincoln, NE 68516

600 N Cotner Blvd
Ste 208
Lincoln, NE 68505

2808 S 80th Ave
Ste 210
Omaha, NE 68124

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 5

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": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1811977580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N COTNER BLVD STE 208",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685052343",
            "telephone_number": "402-464-5969",
            "fax_number": "402-464-3657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N COTNER BLVD STE 208",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685052343",
            "telephone_number": "402-464-5969",
            "fax_number": "402-464-3657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAE",
        "first_name": "SUZAN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-19",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NE",
            "license": "32635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.