Provider Demographics
NPI:1306849005
Name:LINCOLN SURGERY CENTER LLC
Entity type:Organization
Organization Name:LINCOLN SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:E
Authorized Official - Last Name:SUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-484-9000
Mailing Address - Street 1:1710 S 70TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-1676
Mailing Address - Country:US
Mailing Address - Phone:402-484-9090
Mailing Address - Fax:402-483-0476
Practice Address - Street 1:1710 S 70TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-1676
Practice Address - Country:US
Practice Address - Phone:402-484-9090
Practice Address - Fax:402-483-0476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-27
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEH000103284300000X, 284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE60005OtherBCBS
NE10024946500Medicaid
NE5000143OtherUNITED HEALTHCARE
NE10024946500Medicaid
NE430078236Medicare PIN
NE280127Medicare Oscar/Certification
NE60005OtherBCBS
NE5000143OtherUNITED HEALTHCARE
NE099319Medicare PIN
NE276228Medicare PIN
NE276229Medicare PIN
NE430078235Medicare PIN
NE099306Medicare PIN