Individual provider Active NPI

Shaun Michael Luebbe, PA

  • Medical Physician Assistant
  • Lincoln, NE
National Provider Identifier
1942476239
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2271 Issued in NE
Practice address
4201 S 14TH St
Lincoln, NE 68502-5336
Phone
(402) 479-3292
NPI assigned
May 6, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2271 NE Primary

Addresses

Primary practice location

4201 S 14TH St
Lincoln, NE 68502-5336

Mailing address

PO Box 67250
Apt. #204
Lincoln, NE 68506-7250
Phone (402) 328-2907

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140915001177 NE Practitioner - Physician Assistant 8628297264 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bryan Physician NetworkGroup PAC ID 7315915873, 236 clinicians
Value Based Long Term Care B PCGroup PAC ID 4082017884, 28 clinicians
Nebraska House Call Physicians PCGroup PAC ID 7517911555, 23 clinicians

Practice addresses (Care Compare)

2300 S 16TH St
Bryan Medical Center
Lincoln, NE 68502-3704
Phone (402) 481-1111

3900 Pine Lake Rd
Suite 5
Lincoln, NE 68516-5489
Phone (402) 730-6870

Hospital & facility affiliations

  • Bryan Medical Center Hospital, Lincoln, NE, CCN 280003

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2271NEMDMedical Physician Assistant

Organizations & group practices 4

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 3

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": "1210032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1942476239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67250",
            "address_2": "APT. #204",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685067250",
            "telephone_number": "402-328-2907",
            "fax_number": "888-965-0959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 S 14TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685025336",
            "telephone_number": "402-479-3292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUEBBE",
        "first_name": "SHAUN",
        "middle_name": "MICHAEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-06",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "2271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.