INNOVATIVE PAIN & SPINE SPECIALISTS – Interventional Pain Medicine Physician, NPI 1245692581
Interventional Pain Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for INNOVATIVE PAIN & SPINE SPECIALISTS
17030 Lakeside Hills Plz Ste 202
Omaha, NE 681302442
Phone: (402) 413-5010
Fax: (402) 413-5009
Type: Location
2022 13th St
Auburn, NE 683051701
Phone: (402) 413-5010
Fax: (402) 413-5009
Type: Location
Stephanie Lane, Lincoln, Lancaster County, Nebraska, 68516, United States
LINCOLN, NE 685165359
Phone: (402) 413-5010
Type: Location
6131, South Lincoln Memorial Parkway, Blackland, Blue Mound, Macon County, Illinois, 62513, United States
LINCOLN, NE 685060131
Phone: (402) 499-5447
Type: Mailing
7121 STEPHANIE LN STE 102
LINCOLN, NE 685165352
Phone: (970) 663-2742
Fax: (970) 342-2093
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2016-06-10
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-01-31 (862 days ago).
Enrollment records
1
Earliest due date
2024-01-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20160610000047 | O | Clinic/Group Practice | NE | 2024-01-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 68130)
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