PARK STREET MEDICAL CLINIC
NPI 1720505522
Clinic/Center - Rural Health in Genoa, NE
NPI Status: Active since August 23, 2017
Contact Information
505 S PARK ST
GENOA, NE
ZIP 68640
Phone: (402) 993-2205
Fax: (402) 993-2595
- Organization
- Clinic/Center
- Rural Health
- Accepts Insurance
- CLIA Number: 28D2016795
- CLIA Cert. Type: Rural Health Clinic
- CLIA Exp. Date: 11-23-2026
About PARK STREET MEDICAL CLINIC
This page provides the complete NPI Profile along with additional information for Park Street Medical Clinic, a primary care provider established in Genoa, Nebraska operating as a Clinic/center, focusing in rural health . The healthcare provider is registered in the NPI registry with number 1720505522 assigned on August 2017. The practitioner's primary taxonomy code is 261QR1300X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The provider's other name is Park Street Medical Clinic. The authorized official of this NPI record is Amanda Roebuck (Ceo)
- NPI
- 1720505522
- Provider Legal Name
- CITY OF GENOA
- Other Organization Name
- PARK STREET MEDICAL CLINIC
- Other Name Type
- Other Name (5)
- Entity Type
- Organization
- Location Address
- 505 S PARK ST GENOA, NE 68640
- Location Phone
- (402) 993-2205
- Location Fax
- (402) 993-2595
- Mailing Address
- PO BOX 425 GENOA, NE 68640
- Mailing Phone
- (402) 993-2206
- Mailing Fax
- (402) 993-2595
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 08-23-2017
- Last Update Date
- 01-23-2020
- Code Navigator
A primary care provider (PCP) like Park Street Medical Clinic 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 .
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 Rural Health
- Taxonomy Code
- 261QR1300X
- 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:
- 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
- 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 6000 Premier Select BlueChoice 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 HSA 6500 Premier Select BlueChoice - EPO
- HeartlandBlue Bronze Standard 7500 Blueprint Health - EPO
- HeartlandBlue Bronze Standard 7500 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
- 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, Dental + Vision, No Referrals) - EPO
- UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Standard (No Referrals) - EPO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
- UHC Gold Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
- UHC Gold Standard (No Referrals) - EPO
- UHC Gold Value ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - EPO
- UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
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
- 28D2016795
- Facility Type
- Rural Health Clinic
- Certificate Effective Date
- November 24, 2024
- Certificate Expiration Date
- November 23, 2026
- Laboratory Director
- DR. BRIAN BUHLKE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Park Street Medical Clinic 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 1720505522, we treat the final digit (2) 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 48. The final step is to find the difference between that total and the next multiple of ten (50 - 48 = 2).
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 48 is 50. 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.
GENOA, NE 68640
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1720505522, enumerated as an "organization" on August 23, 2017.
The provider is located at 505 S PARK ST GENOA, NE 68640 and the phone number is (402) 993-2205.
Clinic/Center with taxonomy code 261QR1300X and a focus in Rural Health.
The provider might be accepting Accepts: Ambetter from Home State Health, Ambetter from. Please consult your insurance carrier or call the provider to verify.
