PINE LAKE BEHAVIORAL HEALTH
NPI 1003310061
Clinic/Center in Lincoln, NE
NPI Status: Active since March 22, 2018
Contact Information
9100 ANDERMATT DRIVE SUITE 1
LINCOLN, NE
ZIP 68526
Phone: (402) 434-2730
Fax: (402) 434-3970
- Organization
- Clinic/Center
- Accepts Insurance
- CLIA Number: 28D2077900
- CLIA Cert. Type: Ancillary Testing Site in Health Care Center
- CLIA Exp. Date: 05-15-2028
About PINE LAKE BEHAVIORAL HEALTH
This page provides the complete NPI Profile along with additional information for Pine Lake Behavioral Health, a provider established in Lincoln, Nebraska operating as a Clinic/center. The healthcare provider is registered in the NPI registry with number 1003310061 assigned on March 2018. The practitioner's primary taxonomy code is 261Q00000X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The provider's is doing business as Pine Lake Behavioral Health. The authorized official of this NPI record is Jared Wade Ray Lipc, Ladc (Director Of Operations)
- NPI
- 1003310061
- Provider Legal Name
- PINE LAKE BEHAVIORAL HEALTH, LLC.
- Other Organization Name
- PINE LAKE BEHAVIORAL HEALTH
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 9100 ANDERMATT DRIVE SUITE 1 LINCOLN, NE 68526
- Location Phone
- (402) 434-2730
- Location Fax
- (402) 434-3970
- Mailing Address
- 9100 ANDERMATT DR STE 1 LINCOLN, NE 68526
- Mailing Phone
- (402) 434-2730
- Mailing Fax
- (402) 434-3970
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-22-2018
- Last Update Date
- 02-24-2020
- Code Navigator
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
Clinic/Center
- Taxonomy Code
- 261Q00000X
- Type
- Ambulatory Health Care Facilities
- License State
- NE
- Taxonomy Description
- A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
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 | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | |
| 2 | 333600000X | Suppliers | Pharmacy |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- HeartlandBlue Bronze 0% Coinsurance after Deductible NEtwork Blue - EPO
- HeartlandBlue Bronze 0% Coinsurance after Deductible NEtwork Blue PPO - PPO
- HeartlandBlue Bronze 6000 Premier Select BlueChoice w/ Adult Vision - EPO
- HeartlandBlue Bronze HSA 6500 NEtwork Blue - EPO
- HeartlandBlue Bronze HSA 6500 NEtwork Blue PPO - PPO
- HeartlandBlue Bronze HSA 6500 Premier Select BlueChoice - EPO
- HeartlandBlue Bronze Standard 7500 NEtwork Blue - EPO
- HeartlandBlue Bronze Standard 7500 NEtwork Blue PPO - PPO
- HeartlandBlue Bronze Standard 7500 Premier Select BlueChoice - EPO
- HeartlandBlue Gold $0 PCP Visit 1500 NEtwork Blue - EPO
- 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
- Bronze Classic - EPO
- Bronze Classic | with Bryan Health - EPO
- Bronze Classic Standard - EPO
- Bronze Classic Standard | with Bryan Health - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Bronze Elite + PCP Saver Plus | with Bryan Health - EPO
- Bronze Simple Diabetes - EPO
- Bronze Simple Diabetes | with Bryan Health - EPO
- Gold Classic Standard - EPO
- Gold Classic Standard | with Bryan Health - EPO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
- UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Essential (No Referrals) - EPO
- UHC Bronze Standard (No Referrals) - EPO
- UHC Bronze Standard (No Referrals) - HMO
- UHC Bronze Standard+ (Dental + Vision, No Referrals) - EPO
- UHC Bronze Value ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Bronze Value+ ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
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.
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 |
|---|---|---|---|
| NA3283 | OTHER (01) | NE | MEDICARE PTAN |
| 10026721201 | MEDICAID (05) | NE | |
| DY5949 | OTHER (01) | NE | RR MEDICARE PTAN |
| 10026721200 | MEDICAID (05) | NE |
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
- 28D2077900
- Facility Type
- Ancillary Testing Site in Health Care Center
- Certificate Effective Date
- May 16, 2026
- Certificate Expiration Date
- May 15, 2028
- Laboratory Director
- MR. JARED RAY
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Pine Lake Behavioral Health to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for PINE LAKE BEHAVIORAL HEALTH
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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 1003310061, we treat the final digit (1) 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 39. The final step is to find the difference between that total and the next multiple of ten (40 - 39 = 1).
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 39 is 40. The difference is the calculated check digit.
Other Providers at the Same Location
The following 4 providers are registered at the same or a nearby location.
LINCOLN, NE 68526
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1003310061, enumerated as an "organization" on March 22, 2018.
The provider is located at 9100 ANDERMATT DRIVE SUITE 1 LINCOLN, NE 68526 and the phone number is (402) 434-2730.
Clinic/Center with taxonomy code 261Q00000X.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Nebraska, Medica,. Please consult your insurance carrier or call the provider to verify.
