LAKESIDE AMBULATORY SURGICAL CENTER LLC
NPI 1528026788
Clinic/Center - Ambulatory Surgical in Omaha, NE

NPI Status: Active since May 03, 2006

Contact Information

17030 LAKESIDE HILLS PLZ STE 110
OMAHA, NE
ZIP 68130
Phone: (402) 758-5120
Fax: (402) 758-5087

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • Accepts Insurance
  • CLIA Number: 28D1053164
  • CLIA Cert. Type: Ambulatory Surgery Center
  • CLIA Exp. Date: 04-16-2028

About LAKESIDE AMBULATORY SURGICAL CENTER LLC

This page provides the complete NPI Profile along with additional information for Lakeside Ambulatory Surgical Center Llc, a provider established in Omaha, Nebraska operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1528026788 assigned on May 2006. The practitioner's primary taxonomy code is 261QA1903X. The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Alicia K Wagner (Ceo)

NPI
1528026788
Provider Name
LAKESIDE AMBULATORY SURGICAL CENTER LLC
Entity Type
Organization
Location Address
17030 LAKESIDE HILLS PLZ STE 110 OMAHA, NE 68130
Location Phone
(402) 758-5120
Location Fax
(402) 758-5087
Mailing Address
17030 LAKESIDE HILLS PLZ STE 110 OMAHA, NE 68130
Mailing Phone
(402) 758-5120
Mailing Fax
(402) 758-5087
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-03-2006
Last Update Date
11-13-2025
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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 Ambulatory Surgical

Taxonomy Code
261QA1903X
Type
Ambulatory Health Care Facilities

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 Blueprint Health w/ Adult Vision - EPO
  • HeartlandBlue Bronze HSA 6500 Blueprint Health - EPO
  • HeartlandBlue Bronze HSA 6500 NEtwork Blue - EPO
  • HeartlandBlue Bronze HSA 6500 NEtwork Blue PPO - PPO
  • HeartlandBlue Bronze Standard 7500 Blueprint Health - EPO
  • HeartlandBlue Bronze Standard 7500 NEtwork Blue - EPO
  • HeartlandBlue Bronze Standard 7500 NEtwork Blue PPO - PPO
  • HeartlandBlue Gold $0 PCP Visit 1500 Blueprint Health - EPO
  • HeartlandBlue Gold $0 PCP Visit 1500 NEtwork Blue - EPO
  • HeartlandBlue Gold $0 PCP Visit 1500 NEtwork Blue PPO - PPO
  • HeartlandBlue Gold 1000 Blueprint Health w/ Adult Vision - EPO
  • HeartlandBlue Gold 1000 NEtwork Blue w/ Adult Vision - EPO
  • HeartlandBlue Gold 1000 NEtwork Blue w/ Adult Vision PPO - PPO
  • HeartlandBlue Gold Standard 2000 Blueprint Health - EPO
  • HeartlandBlue Gold Standard 2000 NEtwork Blue - EPO
  • HeartlandBlue Gold Standard 2000 NEtwork Blue PPO - PPO
  • HeartlandBlue Silver $0 PCP Visit 4500 Blueprint Health - EPO
  • HeartlandBlue Silver $0 PCP Visit 4500 NEtwork Blue - EPO
  • Bronze Classic - EPO
  • Bronze Classic | with Bryan Health - EPO
  • Bronze Classic 4700 - 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
  • Gold Elite - EPO
  • Gold Elite | with Bryan Health - EPO
  • Secure - EPO
  • Silver Classic - EPO
  • Silver Classic Standard - EPO
  • Silver Classic Standard | with Bryan Health - EPO
  • Silver Simple Diabetes - EPO
  • Silver Simple Diabetes | with Bryan Health - EPO
  • Silver Simple PCP Saver - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

ALICIA K WAGNER

Authorized Official Title
CEO
Authorized Official Phone
(402) 758-5212

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Complex repair of detached retina and drainage of eye fluid between lens and retina

This procedure involves reattaching your detached retina, a vital layer at the back of your eye. Simultaneously, excess fluid between your lens and retina is drained. This helps restore vision and prevent further eye damage.

This service was performed 15 times for 14 patients

Injection, bupivacaine liposome, 1 mg

Bupivacaine liposome is a local anesthetic used to numb a specific area of the body and reduce pain or discomfort associated with surgical procedures. The 1 mg dosage is injected by a healthcare professional at the required site.

This service was performed 12,768 times for 47 patients

Removal of gallbladder using an endoscope

This procedure, known as endoscopic gallbladder removal, involves a surgeon using a special tool called an endoscope to remove your gallbladder through small incisions. It's typically done to treat gallstones and related complications. It's a less invasive method, often leading to quicker recovery.

This service was performed 11 times for 11 patients

Removal of membrane of retina

Removal of the retina's membrane is a surgical procedure aimed at treating eye conditions affecting the retina's function. It involves a delicate operation to eliminate scar tissue or membranes causing vision problems. The procedure can help improve or stabilize vision.

This service was performed 18 times for 18 patients

Removal of membrane of retina with removal of internal limiting membrane of retina

This procedure involves the surgical removal of a thin layer, called the membrane, from the retina. It also includes the removal of the innermost layer of the retina, known as the internal limiting membrane. This can help improve vision.

This service was performed 31 times for 31 patients

Repair of detached retina with drainage and removal of eye fluid between lens and retina

This procedure addresses a detached retina, a serious eye condition. It involves draining fluid from between the lens and retina, allowing the retina to reattach. Then, the eye fluid is removed to prevent future detachments. It's a crucial step for vision restoration.

This service was performed 19 times for 19 patients

Repair of groin hernia (5 years or older)

Repair of a groin hernia is a procedure aimed at fixing an abnormal bulge that can occur in the area between your abdomen and thigh. This condition happens when tissue pushes through a weak spot in your lower abdominal wall. The repair procedure returns this tissue back to its proper place.

This service was performed 11 times for 11 patients

Repair of shoulder rotator cuff using an endoscope

This procedure, known as arthroscopic rotator cuff repair, helps fix tears in the shoulder's rotator cuff. An endoscope, a small camera, is used to view the shoulder inside. Using small tools, the surgeon repairs the torn tissue. This minimally invasive approach often leads to a quicker recovery.

This service was performed 13 times for 13 patients

Replacement of knee joint, both sides of knee

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

This service was performed 36 times for 34 patients

Replacement of thigh bone and hip joint with prosthesis

This procedure, known as hip arthroplasty, involves replacing your damaged thigh bone and hip joint with artificial parts, called a prosthesis. It helps relieve pain, improve mobility, and enhance your quality of life.

This service was performed 14 times for 14 patients

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
28D1053164
Facility Type
Ambulatory Surgery Center
Certificate Effective Date
April 17, 2026
Certificate Expiration Date
April 16, 2028
Laboratory Director
DANIEL MCGRANE
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Lakeside Ambulatory Surgical Center Llc 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.

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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 1528026788, we treat the final digit (8) 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 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).

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.

Pos 1
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
2
Doubled → 4
Pos 4
8
Unchanged
Pos 5
0
Doubled → 0
Pos 6
2
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
7
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
8
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 2 → 4 0 → 0 6 → 12 → 3 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 4 + 8 + 0 + 2 + 1 + 2 + 7 + 1 + 6 + 24 = 62

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 62 is 70. The difference is the calculated check digit.

70 - 62 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1528026788.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1528026788, enumerated as an "organization" on May 03, 2006.

The provider is located at 17030 LAKESIDE HILLS PLZ STE 110 OMAHA, NE 68130 and the phone number is (402) 758-5120.

Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Nebraska and Oscar. Please consult your insurance carrier or call the provider to verify.