Individual provider Active NPI

Maria Christina M Lyons, PA-C

  • Physician Assistant
  • Omaha, NE
National Provider Identifier
1851627285
Registry record updated Jun 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
10707 Pacific St Ste 101
Omaha, NE 68114
Phone
(402) 397-7989
NPI assigned
Oct 20, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2241 NE
Medical Physician Assistant 363AM0700X 092848 IA
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

10707 Pacific St Ste 101
Omaha, NE 68114

Mailing address

15515 Jackson Cir
Omaha, NE 68154-2734
Phone (480) 646-6826

Other practice location 1

875 N Greenfield Road #105
Gilbert, AZ 85234
Phone (480) 897-2727

Other identifiers 1

IdentifierTypeStateIssuer
47077934913MedicaidNE

Other names 1

  • Christina Malazarte Lyons Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Urohart

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, NE, IA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20091207000438 AZ Practitioner - Physician Assistant 7719026616 Reassigns benefits to 1 organization
I20180831001186 NE Practitioner - Physician Assistant 7719026616 Reassigns benefits to 1 organization
I20180911002498 IA Practitioner - Physician Assistant 7719026616 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2241NEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Urology Center PC CurrentSince Aug 13, 2018 Accepting new patients

Locations

3434 W Broadway
Ste 102
Council Bluffs, IA 51501
Phone (712) 325-0014

10707 Pacific St
Ste 101
Omaha, NE 68114

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1255996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561075200000",
    "number": "1851627285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15515 JACKSON CIR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681542734",
            "telephone_number": "480-646-6826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10707 PACIFIC ST STE 101",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68114",
            "telephone_number": "402-397-7989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "875 N Greenfield Road #105",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "85234",
            "country_code": "US",
            "telephone_number": "480-897-2727",
            "fax_number": "480-982-3035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYONS",
        "first_name": "MARIA CHRISTINA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-20",
        "last_updated": "2019-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "2241",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IA",
            "license": "092848",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47077934913",
            "state": "NE"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Urohart",
            "affiliation": "N",
            "endpointDescription": "computer",
            "address_1": "10707 Pacific St Ste 101",
            "city": "Omaha",
            "state": "NE",
            "country_code": "US",
            "postal_code": "68114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "LYONS",
            "middle_name": "MALAZARTE",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.