Individual provider Active NPI

Jeri L Spatz, PA

  • Medical Physician Assistant
  • Lincoln, NE
National Provider Identifier
1992294631
Registry record updated May 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
2222 S 16TH St Ste 405
Lincoln, NE 68502-3793
Phone
(402) 474-3704
Fax
(402) 474-3748
NPI assigned
May 8, 2018
Last updated
May 8, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2018

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 NE Primary

Addresses

Primary practice location

2222 S 16TH St Ste 405
Lincoln, NE 68502-3793

Mailing address

2222 S 16TH St Ste 405
Lincoln, NE 68502-3793
Phone (402) 474-3704

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
I20180828004326 NE Practitioner - Physician Assistant 1153671961 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Value Based Long Term Care B PCGroup PAC ID 4082017884, 28 clinicians

Practice addresses (Care Compare)

1201 Park Dr
Hickman, NE 68372-1448
Phone (402) 204-4103

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

7121 Stephanie LN
Suite 100
Lincoln, NE 68516-5359
Phone (402) 466-0100

7350 Willowbrook LN
Lincoln, NE 68516-7781

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Memorial Hospital District Current Accepting new patients
Community Memorial Hospital District CurrentSince Jan 1, 2020 Accepting new patients
Community Memorial Hospital District PastSince Feb 9, 2025 Accepting new patients

Locations

1201 Park Dr
Hickman, NE 68372
Phone (402) 204-4103

7121 Stephanie Ln
Ste 100
Lincoln, NE 68516
Phone (402) 420-3500

7350 Willowbrook Ln
Ste 101
Lincoln, NE 68516
Phone (402) 269-2011

2731 Healthcare Dr
Syracuse, NE 68446
Phone (402) 269-2011

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525737600000",
    "number": "1992294631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 S 16TH ST STE 405",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685023793",
            "telephone_number": "402-474-3704",
            "fax_number": "402-474-3748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 S 16TH ST STE 405",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685023793",
            "telephone_number": "402-474-3704",
            "fax_number": "402-474-3748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPATZ",
        "first_name": "JERI",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-08",
        "last_updated": "2018-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.