Individual provider Active NPI

Carolyn Elaine Lussenhop, MD

  • Hospitalist Physician
  • Fremont, NE
National Provider Identifier
1982391843
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
37498 Issued in NE
Practice address
450 E 23Rd St
Fremont, NE 68025-2303
Phone
(402) 721-1610
Fax
(402) 941-7272
NPI assigned
Apr 20, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X 37498 NE Primary

Addresses

Primary practice location

450 E 23Rd St
Fremont, NE 68025-2303

Mailing address

PO Box 3755
Omaha, NE 68103-0755
Phone (402) 354-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20230913001146 MN Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 4082078811

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4682 Country SHRS SW
Alexandria, MN 56308-6067

825 S 169TH St
Omaha, NE 68118-9300

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1681948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1982391843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3755",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681030755",
            "telephone_number": "402-354-2100",
            "fax_number": "402-354-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 E 23RD ST",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252303",
            "telephone_number": "402-721-1610",
            "fax_number": "402-941-7272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSSENHOP",
        "first_name": "CAROLYN",
        "middle_name": "ELAINE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-20",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": "NE",
            "license": "37498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, NE

Sources for this page

Verify at the official NPI Registry.