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PARK STREET MEDICAL CLINIC
NPI 1720505522
Clinic/Center - Rural Health in Genoa, NE

Active since August 23, 2017CLIA 28D2016795 · Waiver
505 S PARK ST, GENOA, NE 68640(402) 993-2205(402) 993-2595 Get Directions Write a Review

NPPES record last updated: January 23, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 23, 2020, Nov 14, 2017, Aug 23, 2017 (3 updates tracked since 2017).

About Park Street Medical Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PARK STREET MEDICAL CLINIC (NPI 1720505522) is a healthcare organization registered as a rural health in Genoa, Nebraska and active in the NPI registry since August 2017. The organization holds a CLIA Waiver certificate valid through November 23, 2026 and lists Amanda Roebuck, Ceo, as its authorized official.

NPPES Registry Identity

NPI1720505522
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameCITY OF GENOA
Location Address505 S PARK STGenoa, NE 68640-3036
Mailing AddressPo Box 425Genoa, NE 68640-0425 · (402) 993-2206 · Fax (402) 993-2595
Phone(402) 993-2205
Fax(402) 993-2595
Organization SubpartYes
Authorized OfficialAmanda RoebuckCeo · (402) 993-4583
Enumeration DateAugust 23, 2017
Last NPPES UpdateJanuary 23, 20203 updates tracked since enumeration
✔ NPI 1720505522 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
505 S PARK ST, Genoa, NE 68640
Open in Google Maps ↗

Other Names 1

Other NamePark Street Medical Clinic

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter from Sunflower Health Plan, Ambetter Health and more.Insurance ›

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 28D2016795

Park Street Medical Clinic · Genoa, NE
Active · expires Nov 23, 2026
CLIA Number28D2016795
Laboratory TypeRural Health Clinic
Certificate Effective DateNovember 24, 2024
Certificate Expiration DateNovember 23, 2026
Laboratory DirectorDr. Brian Buhlke
Laboratory Phone(402) 993-2206
Laboratory LocationPark Street Medical Clinic505 South Park Street, Genoa, NE 68640
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CITY OF GENOA
Clinic/Center (Primary Care)
505 S PARK ST
GENOA, NE 68640
Nance County (402) 993-2206
JENNA PATRCIA ABRAMSON PA-C
Family Medicine
505 S PARK ST
GENOA, NE 68640
Nance County (402) 993-2206
MR. STEVE D WATTON PA C
Physician Assistant
505 S PARK ST, PARK STREET MEDICAL CLINIC
GENOA, NE 68640
Nance County (402) 993-2206
MRS. JENNIFER LYNN SWANTEK APRN
Nurse Practitioner (Family)
505 S PARK ST
GENOA, NE 68640
Nance County (402) 993-2206

Frequently 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 City Of Genoa's NPI number?

The NPI number for City Of Genoa is 1720505522. It was assigned to this organization in the NPPES registry on August 23, 2017. The provider is also known as Park Street Medical Clinic.

Where is City Of Genoa located?

City Of Genoa is located at 505 S Park St, Genoa, NE 68640. The listed phone number is (402) 993-2205.

What is City Of Genoa's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does City Of Genoa hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 28D2016795) is associated with this NPI, valid through November 23, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does City Of Genoa accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and Blue Cross and Blue Shield of Nebraska and 2 other insurers list City Of Genoa 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 City Of Genoa was last updated on January 23, 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.