| Alegent Health Lasting Hope Recovery Center Professional Services | |
|
415 S 25th St Omaha NE 68131-3654 | |
| (402) 717-5300 | |
| Not Available |
| Full Name | Alegent Health Lasting Hope Recovery Center Professional Services |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 415 S 25th St, Omaha, Nebraska |
| Authorized Official Name and Position | Evert Kuiper (CEO) |
| Authorized Official Contact | 4023434420 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alegent Health Lasting Hope Recovery Center Professional Services Po Box 641130 Omaha NE 68164-7130 Ph: (404) 717-4277 | Alegent Health Lasting Hope Recovery Center Professional Services 415 S 25th St Omaha NE 68131-3654 Ph: (402) 717-5300 |
| NPI Number | 1184897647 |
|---|---|
| Provider Enumeration Date | 04/07/2008 |
| Last Update Date | 02/10/2022 |
| Medicare PECOS PAC ID | 8224947783 |
|---|---|
| Medicare Enrollment ID | O20041012000940 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184897647 | NPI | - | NPPES |
| Provider Name | Matthew K Egbert |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366490880 PECOS PAC ID: 7012905250 Enrollment ID: I20040505000677 |
| Provider Name | John W Markus |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700974656 PECOS PAC ID: 3971574880 Enrollment ID: I20040804000666 |
| Provider Name | Vijay K Dewan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205817061 PECOS PAC ID: 4688641509 Enrollment ID: I20040910001164 |
| Provider Name | William C Bruns |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265442032 PECOS PAC ID: 0345221750 Enrollment ID: I20050308001200 |
| Provider Name | Zakaria Siddiqui |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124144522 PECOS PAC ID: 6608848502 Enrollment ID: I20050328000531 |
| Provider Name | Sriram Ramaswamy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174570311 PECOS PAC ID: 8426085994 Enrollment ID: I20050726001099 |
| Provider Name | Syed F Qadri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902917552 PECOS PAC ID: 9436168119 Enrollment ID: I20060406000658 |
| Provider Name | William A Marcil |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750393104 PECOS PAC ID: 5193868149 Enrollment ID: I20100130000051 |
| Provider Name | Thomas M Magnuson |
|---|---|
| Provider Type | Practitioner - Geriatric Psychiatry |
| Provider Identifiers | NPI Number: 1962452391 PECOS PAC ID: 8123162740 Enrollment ID: I20100220000322 |
| Provider Name | Shannon M Kinnan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376738898 PECOS PAC ID: 4789718099 Enrollment ID: I20100820001051 |
| Provider Name | Hudson H Hsieh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033269030 PECOS PAC ID: 8921122300 Enrollment ID: I20100908000420 |
| Provider Name | Imad Alsakaf |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295944783 PECOS PAC ID: 4789860297 Enrollment ID: I20110518000362 |
| Provider Name | Jeana L Benton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962694190 PECOS PAC ID: 6204005564 Enrollment ID: I20110803000543 |
| Provider Name | Kofi Amoako Ababio |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669449815 PECOS PAC ID: 5991791774 Enrollment ID: I20120120000371 |
| Provider Name | Sriramamurthy Ravipati |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730239732 PECOS PAC ID: 7810985793 Enrollment ID: I20140624001062 |
| Provider Name | Katherine Elizabeth Yaffe |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659486827 PECOS PAC ID: 6901041292 Enrollment ID: I20140925002485 |
| Provider Name | Piyush Das |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265639140 PECOS PAC ID: 7214060763 Enrollment ID: I20141210000499 |
| Provider Name | Ivan R Delgado Ramos |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982675559 PECOS PAC ID: 9739203340 Enrollment ID: I20141217000892 |
| Provider Name | Salina V Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629461140 PECOS PAC ID: 2860719762 Enrollment ID: I20150401002104 |
| Provider Name | Virginia J Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568827095 PECOS PAC ID: 6103129184 Enrollment ID: I20160126000306 |
| Provider Name | Andrew Robert Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871908814 PECOS PAC ID: 5496976086 Enrollment ID: I20180618001664 |
| Provider Name | Nargis Sadat |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306253448 PECOS PAC ID: 1951521319 Enrollment ID: I20180717001064 |
| Provider Name | Mark E Thomsen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972988921 PECOS PAC ID: 1254611635 Enrollment ID: I20190701001139 |
| Provider Name | Chloe B Olson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881057156 PECOS PAC ID: 6507119369 Enrollment ID: I20200611002182 |
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