Pine Lake Behavioral Health - Medicare Primary Care in Lincoln, NE

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Pine Lake Behavioral Health is a medicare enrolled primary clinic (Clinic/center) in Lincoln, Nebraska. The current practice location for Pine Lake Behavioral Health is 9100 Andermatt Drive Suite 1, Lincoln, Nebraska. For appointments, you can reach them via phone at (402) 434-2730. The mailing address for Pine Lake Behavioral Health is 9100 Andermatt Dr Ste 1, Lincoln, Nebraska and phone number is (402) 434-2730.

Pine Lake Behavioral Health is licensed to practice in Nebraska (license number ). The clinic also participates in the medicare program and its NPI number is 1003310061. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (402) 434-2730.

Contact Information

Pine Lake Behavioral Health
9100 Andermatt Drive Suite 1
Lincoln
NE 68526-0000
(402) 434-2730
(402) 434-3970

Map and Direction


Primary Care Clinic Profile

Full NamePine Lake Behavioral Health
SpecialityClinic/Center
Location9100 Andermatt Drive Suite 1, Lincoln, Nebraska
Authorized Official Name and PositionJared Wade Ray (DIRECTOR OF OPERATIONS)
Authorized Official Contact4024342730
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Pine Lake Behavioral Health
9100 Andermatt Dr Ste 1
Lincoln
NE 68526-6700

Ph: (402) 434-2730		Pine Lake Behavioral Health
9100 Andermatt Drive Suite 1
Lincoln
NE 68526-0000

Ph: (402) 434-2730

NPI Details:

NPI Number1003310061
Provider Enumeration Date03/22/2018
Last Update Date02/24/2020

Medicare PECOS Information:

Medicare PECOS PAC ID7810250164
Medicare Enrollment IDO20180418003008

Medical Identifiers

Medical identifiers for Pine Lake Behavioral Health such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1003310061NPI-NPPES
10026721200MedicaidNE
NA3283OtherNEMEDICARE PTAN
10026721201MedicaidNE
DY5949OtherNERR MEDICARE PTAN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261Q00000XClinic/center (Nebraska)Primary
261QM0801XClinic/center - Mental Health (including Community Mental Health Center) (* (Not Available))Secondary
333600000XPharmacy (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Pine Lake Behavioral Health acts as a billing entity for following providers:
Provider NameLiane E Donovan
Provider TypePractitioner - Interventional Pain Management
Provider IdentifiersNPI Number: 1093770687
PECOS PAC ID: 0648233320
Enrollment ID: I20041105000419
Provider NameJohn R Massey
Provider TypePractitioner - Pain Management
Provider IdentifiersNPI Number: 1922063528
PECOS PAC ID: 0547223224
Enrollment ID: I20041108000779
Provider NameKelley S Hanau
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1225235898
PECOS PAC ID: 3274625215
Enrollment ID: I20070822001404
Provider NameJodi M Fuehrer
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1982861589
PECOS PAC ID: 0446325351
Enrollment ID: I20080812000342
Provider NameAdam S Brank
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1033208087
PECOS PAC ID: 0840366589
Enrollment ID: I20080904000267
Provider NameLisa M Jones
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1306823422
PECOS PAC ID: 5294895637
Enrollment ID: I20081114000788
Provider NameHong Cui
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1316038664
PECOS PAC ID: 3678634383
Enrollment ID: I20090825000075
Provider NameRyan Christopher Ernst
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1811131840
PECOS PAC ID: 2062546989
Enrollment ID: I20100813001039
Provider NameRick R Mcneese
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1982777579
PECOS PAC ID: 3375701220
Enrollment ID: I20120223000044
Provider NameKimberly S Waters
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1528449741
PECOS PAC ID: 0244546554
Enrollment ID: I20150901003151
Provider NameErin Simanic
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1326594045
PECOS PAC ID: 9537457098
Enrollment ID: I20161017000510
Provider NameBryan J Beals
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1710141288
PECOS PAC ID: 8426207945
Enrollment ID: I20170901002938
Provider NameRichard A. Fermelia
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1851486831
PECOS PAC ID: 4587769369
Enrollment ID: I20180814002789
Provider NameKatherine M Doud
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1508109638
PECOS PAC ID: 2062792120
Enrollment ID: I20190604002430
Provider NameJessica M Harms
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1487078135
PECOS PAC ID: 1456727924
Enrollment ID: I20221025001819
Provider NameFahima F Hasan
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1043933740
PECOS PAC ID: 5799154530
Enrollment ID: I20221216002168
Provider NameAustralia Hruby
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1780266049
PECOS PAC ID: 8123493533
Enrollment ID: I20230417000465
Provider NameCarrie Papenhagen
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1942497862
PECOS PAC ID: 7517301211
Enrollment ID: I20240221002817
Provider NameLois Relys
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1285882993
PECOS PAC ID: 6608210307
Enrollment ID: I20240221002856
Provider NameJared Ray
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1831328103
PECOS PAC ID: 5597991307
Enrollment ID: I20240221003290
Provider NameKerry Ropte
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1801168653
PECOS PAC ID: 9739523440
Enrollment ID: I20240221003451
Provider NameStephanie Delgado
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1194207142
PECOS PAC ID: 6800230517
Enrollment ID: I20240221003536
Provider NameTimothy Luedtke
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1679971337
PECOS PAC ID: 6800230418
Enrollment ID: I20240221003592
Provider NameWilliam Wysocki
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1598219974
PECOS PAC ID: 6002250610
Enrollment ID: I20240221003880
Provider NameRonicka Schottel
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1225479843
PECOS PAC ID: 5991149429
Enrollment ID: I20240222003617
Provider NameBeau Sedlacek
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1821574377
PECOS PAC ID: 3779928569
Enrollment ID: I20240304000113
Provider NameLindsey Gonzales
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1538524897
PECOS PAC ID: 6901241652
Enrollment ID: I20240304002571
Provider NameDonald Holmquist
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1205041175
PECOS PAC ID: 9335423078
Enrollment ID: I20240305003733

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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.