LAKESIDE AMBULATORY SURGICAL CENTER LLC – Ambulatory Surgical Clinic/Center, NPI 1528026788
Ambulatory Surgical Clinic/Center
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for LAKESIDE AMBULATORY SURGICAL CENTER LLC
17030 LAKESIDE HILLS PLZ STE 110
OMAHA, NE 681302440
Phone: (402) 758-5120
Fax: (402) 758-5087
Type: Location
17030, Lakeside Hills Plaza, Millard, Omaha, Douglas County, Nebraska, 68130, United States
SUITE 206
OMAHA, NE 681302396
Phone: (402) 758-5120
Fax: (402) 758-5087
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: 2006-11-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-08-31 (283 days ago).
Enrollment records
1
Earliest due date
2025-08-31
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 |
|---|---|---|---|---|
| O20061109000682 | O | Ambulatory Surgical Center | NE | 2025-08-31 |
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| C9290 | Injection, bupivacaine liposome, 1 mg | 12,768 | 47 | $0 |
| 27447 | Replacement of knee joint, both sides of knee | 36 | 34 | $0 |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 31 | 31 | $0 |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 19 | 19 | $0 |
| 67041 | Removal of membrane of retina | 18 | 18 | $0 |
Insurance plans in this area (ZIP 68130)
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