Yazan Odeh Ali Alzedaneen
Individual provider Active NPI Internal Medicine Physician · Lincoln, NE
NPI 1821607102 · NPPES record last updated Jul 11, 2025
Key facts
- NPI
- 1821607102
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 36777 (NE)
- Practice address
- 3901 Pine Lake Rd Ste 410
Lincoln, NE 68516-5415 - Phone
- (402) 483-8700
- NPI assigned
- Jul 23, 2020
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Bryan Physician Network
Practice addresses (Care Compare)
3901 Pine Lake Rd
Suite 410
Lincoln, NE 68516-5415
Phone (402) 483-8700
Hospital & facility affiliations
- Bryan Medical Center
- Kearney Regional Medical Center
- Beatrice Community Hospital & Health Center, Inc
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NE
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250718001377 | NE | Practitioner - Internal Medicine | 6002322930 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36777 | NE | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pine Lake Behavioral Health, LLC. | Current |
Accepting new patients | |
| Bryan Physician Network | Internal Medicine | Current |
Accepting new patients |
Locations
3901 Pine Lake Rd
Ste 410
Lincoln, NE 68516
Phone (402) 434-2730
2300 S 16th St
Lincoln, NE 68502
Phone (402) 434-6042
Interoperability endpoints
- yalzadaneen205308@hisp.bryanhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | 36777 | NE | Yes |
Addresses
Primary practice location
3901 Pine Lake Rd Ste 410
Lincoln, NE 68516-5415
Mailing address
PO Box 860876
Minneapolis, MN 55486-0876
Phone (402) 483-8590
Other providers in Lincoln, NE
- Jodie Alvarez
- Melissa Alvarez
- Nohely Alvarez
- Yvonne Alvarez
- Always Here Home Health LLC
- Sora R Alzubeidy
- Raya Alzuhair
- Amanacare, LLC
- Amanda Austin-Mafilika Counseling
- Amanda K. Schnee, PH.D., LLC
All providers in Lincoln, NE · Internal Medicine Physician in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.