BLOOMFIELD MEDICAL CLINIC, PC
NPI 1003091497
Physician Assistant - Medical in Bloomfield, NE
NPI Status: Active since January 03, 2008
Contact Information
105 S BROADWAY AVENUE
BLOOMFIELD, NE
ZIP 68718
Phone: (402) 373-4341
Fax: (402) 373-4344
- Organization
- Physician Assistant
- Medical
- Accepts Insurance
- Medicare Supplier
- Accepts Medicare Approved Payment
- CLIA Number: 28D0455576
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 08-18-2026
About BLOOMFIELD MEDICAL CLINIC, PC
This page provides the complete NPI Profile along with additional information for Bloomfield Medical Clinic, Pc, a primary care provider established in Bloomfield, Nebraska operating as a Physician Assistant, focusing in medical . The healthcare provider is registered in the NPI registry with number 1003091497 assigned on January 2008. The practitioner's primary taxonomy code is 363AM0700X with license number 1040 (NE). The provider is registered as an organization and their NPI record was last updated 16 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Kevin D Lauck Pa-c (President)
- NPI
- 1003091497
- Provider Name
- BLOOMFIELD MEDICAL CLINIC, PC
- Entity Type
- Organization
- Location Address
- 105 S BROADWAY AVENUE BLOOMFIELD, NE 68718
- Location Phone
- (402) 373-4341
- Location Fax
- (402) 373-4344
- Mailing Address
- 105 S BROADWAY AVENUE P O BOX 357 BLOOMFIELD, NE 68718
- Mailing Phone
- (402) 373-4341
- Mailing Fax
- (402) 373-4344
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-03-2008
- Last Update Date
- 03-29-2010
- Code Navigator
A primary care provider (PCP) like Bloomfield Medical Clinic, Pc sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Bloomfield Medical Clinic, Pc is a medicare supplier with PTAN 20628269 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Nebulizer Drugs or Commodes, Urinals, Bedpans or Blood Glucose Monitors/Supplies (Non-Mail Order) or Canes and/or Crutches or Seat Lift Mechanisms or Walkers or Orthoses: Off-The-Shelf or Nebulizer Equipment and/or Supplies.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physician Assistant Medical
- Taxonomy Code
- 363AM0700X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 1040
- License State
- NE
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 110153 (NE) |
Group Taxonomy 193400000X MULTIPLE SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Complete Silver - EPO
- Complete Silver + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Choice Bronze HSA - EPO
- Choice Bronze HSA + Vision + Adult Dental - EPO
- Clear Gold - EPO
- Clear Gold + Vision + Adult Dental - EPO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Bronze - EPO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Bronze + Vision + Adult Dental - HMO
- Clear Gold - EPO
- Clear Gold + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- ConnectPlus $0 Gold - PPO
- ConnectPlus $0 Silver - PPO
- ConnectPlus $10,600 HSA Eligible HDHP - PPO
- ConnectPlus $1800 - PPO
- ConnectPlus $4500 - PPO
- ConnectPlus $6500 HSA Eligible HDHP - PPO
- ConnectPlus $7500 HSA Eligible HDHP - PPO
- ConnectPlus MyWeighForward $2000 - PPO
- ConnectPlus MyWeighForward $6000 - PPO
- ConnectPlus Standard $2000 - PPO
- HeartlandBlue Bronze 0% Coinsurance after Deductible NEtwork Blue - EPO
- HeartlandBlue Bronze 0% Coinsurance after Deductible NEtwork Blue PPO - PPO
- HeartlandBlue Bronze HSA 6500 NEtwork Blue - EPO
- HeartlandBlue Bronze HSA 6500 NEtwork Blue PPO - PPO
- HeartlandBlue Bronze Standard 7500 NEtwork Blue - EPO
- HeartlandBlue Bronze Standard 7500 NEtwork Blue PPO - PPO
- HeartlandBlue Gold $0 PCP Visit 1500 NEtwork Blue - EPO
- HeartlandBlue Gold $0 PCP Visit 1500 NEtwork Blue PPO - PPO
- HeartlandBlue Gold 1000 NEtwork Blue w/ Adult Vision - EPO
- HeartlandBlue Gold 1000 NEtwork Blue w/ Adult Vision PPO - PPO
- Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
- Medica Individual Choice Bronze Share - HMO
- Medica Individual Choice Expanded Bronze Standard - HMO
- Medica Individual Choice Gold $0 Copay PCP Visits - HMO
- Medica Individual Choice Gold Share - HMO
- Medica Individual Choice Gold Standard - HMO
- Medica Individual Choice Silver $0 Copay PCP Visits - HMO
- Medica Individual Choice Silver Share - HMO
- Medica Individual Choice Silver Standard - HMO
- Medica Insure Bronze $0 Copay PCP Visits - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| DO0210 | MEDICARE PIN (08) | NE | |
| S27626 | MEDICARE UPIN (02) | NE | |
| Q14026 | MEDICARE UPIN (02) | NE | |
| NA1045 | MEDICARE PIN (08) | NE | |
| 10025588500 | MEDICAID (05) | NE |
Medical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20628269
- Accepts Medicare Assignment
- YES
- Specialities List
- Pharmacy.
- Competitive Bidding
- NO
Supplies List
- Nebulizer Drugs - Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
- Commodes, Urinals, Bedpans - Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals
- Blood Glucose Monitors/Supplies (Non-Mail Order) - Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
- Canes and/or Crutches - Standard Canes, Quad Canes, Offset Canes, Standard Crutches, Forearm Crutches
- Seat Lift Mechanisms - Lift chair
- Walkers - Standard Walkers, Wheeled Walkers, Folding Walker
- Orthoses: Off-The-Shelf - Met pads, Heel pads, Heel spur pads
- Nebulizer Equipment and/or Supplies - Nebulizers, Atomizers, Filters
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 28D0455576
- Facility Type
- Physician Office
- Certificate Effective Date
- August 19, 2024
- Certificate Expiration Date
- August 18, 2026
- Laboratory Director
- DR. RILEY G. ECKMANN
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Bloomfield Medical Clinic, Pc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1003091497, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 53. The final step is to find the difference between that total and the next multiple of ten (60 - 53 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 53 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1003091497, enumerated as an "organization" on January 03, 2008.
The provider is located at 105 S BROADWAY AVENUE BLOOMFIELD, NE 68718 and the phone number is (402) 373-4341.
Physician Assistant with taxonomy code 363AM0700X and a focus in Medical.
The provider might be accepting Accepts: Ambetter from Home State Health, Ambetter from. Please consult your insurance carrier or call the provider to verify.
