Pine Lake Health LLC
NPI 1417908666 · Family Medicine Physician · Lincoln, NE
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Pine Lake Health LLC is a Family Medicine Physician organization in Lincoln, NE (NPI 1417908666).
Provider details
- NPI number
- 1417908666
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Matthew Glenn, President(402) 423-4200
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Suppliers
- Physician Assistant363A00000X
Physician Assistants & Advanced Practice Nursing Providers
- Nurse Practitioner363L00000X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-05-12
- Last updated
- 2022-08-30
- Certified
- 2022-08-30
Frequently asked questions
- What is Pine Lake Health LLC's NPI number?
- Pine Lake Health LLC's National Provider Identifier (NPI) is 1417908666, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Pine Lake Health LLC?
- Pine Lake Health LLC is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Pine Lake Health LLC located?
- Pine Lake Health LLC's practice location on file with NPPES is 2611 S 70th St, Lincoln, NE 68506-2960.
- What is Pine Lake Health LLC's phone number?
- The practice phone number listed in the NPPES registry for Pine Lake Health LLC is (402) 423-4200.
- Does Pine Lake Health LLC accept Medicare?
- Pine Lake Health LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Pine Lake Health LLC?
- The authorized official listed on Pine Lake Health LLC's NPPES record is Matthew Glenn, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Pine Lake Health LLC's NPI active?
- Yes — Pine Lake Health LLC's NPI (1417908666) is active in the NPPES registry as of the last update on 2022-08-30.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.