PINE LAKE BEHAVIORAL HEALTH
NPI 1003310061
Clinic/Center in Lincoln, NE
About Pine Lake Behavioral Health NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PINE LAKE BEHAVIORAL HEALTH (NPI 1003310061) is a healthcare organization registered as a clinic/center in Lincoln, Nebraska and active in the NPI registry since March 2018. The organization holds a CLIA Waiver certificate valid through May 15, 2028 and lists Jared Wade Ray, Director Of Operations, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Other Names 1
Other Identifiers 4
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Pine Lake Behavioral Health is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
29Medicare enrollment records show 29 clinicians reassign Medicare billing to Pine Lake Behavioral Health, which bills Medicare for the services they deliver. Of these, 15 practice at this address and 25 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 9
Nearest to this location (20)
See all 29Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 28D2077900
Pine Lake Behavioral Health · Lincoln, NEFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Pine Lake Behavioral Health, LLC.'s NPI number?
The NPI number for Pine Lake Behavioral Health, LLC. is 1003310061. It was assigned to this organization in the NPPES registry on March 22, 2018. The provider is doing business as Pine Lake Behavioral Health.
Where is Pine Lake Behavioral Health, LLC. located?
Pine Lake Behavioral Health, LLC. is located at 9100 Andermatt Drive Suite 1, Lincoln, NE 68526. The listed phone number is (402) 434-2730.
What is Pine Lake Behavioral Health, LLC.'s specialty?
The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.
Is Pine Lake Behavioral Health, LLC. enrolled in Medicare?
Yes. Pine Lake Behavioral Health, LLC. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Pine Lake Behavioral Health, LLC.?
According to the CMS Revalidation Reassignment List (October 2026 release), 29 clinicians in 9 Medicare specialties reassign their Medicare billing to Pine Lake Behavioral Health, LLC.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Mental Health Counselor (13), Nurse Practitioner (6) and Clinical Psychologist (4). Of these, 15 practice at this address and 25 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Pine Lake Behavioral Health, LLC. hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 28D2077900) is associated with this NPI, valid through May 15, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Pine Lake Behavioral Health, LLC. accept?
Health plans from Blue Cross and Blue Shield of Nebraska, Oscar Insurance Company and UnitedHealthcare list Pine Lake Behavioral Health, LLC. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Pine Lake Behavioral Health, LLC. was last updated on February 24, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Pine Lake Behavioral Health · NPI 1003310061
Clinic/Center organization in Lincoln, Nebraska. Organization record, active in the CMS NPPES registry since March 22, 2018.
## Identity
- **NPI:** 1003310061 (Entity type: Organization)
- **Enumerated:** March 22, 2018
- **Primary specialty:** Clinic/Center · taxonomy 261Q00000X
- **Legal business name:** Pine Lake Behavioral Health, Llc.
- **Organization subpart:** No
- **Authorized official:** Jared Ray, DIRECTOR OF OPERATIONS
## Practice location
- **Address:** 9100 ANDERMATT DRIVE SUITE 1, Lincoln, NE 68526-0000
- **Phone:** (402) 434-2730 · **Fax:** (402) 434-3970
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 29 clinicians in 9 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Mental Health Counselor (13), Nurse Practitioner (6), Clinical Psychologist (4); 15 practice at this address and 25 within 10 miles; [full list](https://npiprofile.com/npi/1003310061/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 24, 2020
- **Other identifiers:** Other NA3283 (NE); Medicaid 10026721201 (NE); Other DY5949 (NE); and 1 more
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1003310061) · Data from the CMS NPPES public registry.