Individual provider Active NPI

Julie Ann Luzarraga, LICSW

  • Clinical Social Worker
  • Omaha, NE
National Provider Identifier
1912901984
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1031 Issued in NE
Practice address
2126 N 117TH Ave
Omaha, NE 68164-3670
Phone
(402) 934-1018
Fax
(402) 934-5228
NPI assigned
Jun 8, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2373 NE
Clinical Social Worker 1041C0700X 004898 CT
Clinical Social Worker 1041C0700X 1031 NE Primary

Addresses

Primary practice location

2126 N 117TH Ave
Omaha, NE 68164-3670

Mailing address

2126 N 117TH Ave
Omaha, NE 68164-3670
Phone (402) 934-1018

Other identifiers 2

IdentifierTypeStateIssuer
84107OtherNEBLUE CROSS BLUE SHIELD
10024987100MedicaidNE

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050207000674 NE Practitioner - Clinical Social Worker 7315998523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Omaha Integrative Care, LLCGroup PAC ID 4183875776, 15 clinicians

Practice addresses (Care Compare)

2126 N 117TH Ave
Omaha, NE 68164-3670
Phone (402) 934-1617

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1031NEMDPsychologist
004898CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Omaha Integrative Care, LLC Clinical CurrentSince Sep 1, 2012 Accepting new patients
Omaha Integrative Medicine, LLC CurrentSince Jul 1, 2019 Accepting new patients
Great Plains Counseling, LLC Clinical Past Accepting new patients

Locations

2126 N 117th Ave
Omaha, NE 68164
Phone (402) 934-1617

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8127/brand/1/csg/1/fhir/r4

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": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1912901984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2126 N 117TH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681643670",
            "telephone_number": "402-934-1018",
            "fax_number": "402-934-5228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2126 N 117TH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681643670",
            "telephone_number": "402-934-1018",
            "fax_number": "402-934-5228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUZARRAGA",
        "first_name": "JULIE",
        "middle_name": "ANN",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-08",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "2373",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "004898",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "1031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "84107",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10024987100",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.