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Randall Scott Lienemann

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

987400 Nebraska Medical Ctr, Omaha, NE 68198-1799

PECOS Enrollment

This provider is enrolled in PECOS as RANDALL LIENEMANN.

Based on the most recent information from CMS, provider Randall Scott Lienemann is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1629025879
Provider Type
Individual
Full Name
Lienemann, Randall Scott
Credential
PHYSICIAN ASST PA C

Gender
Male
Sole Proprietor
No
Enumeration Date
5/30/2006
Last Updated
4/16/2018

Contact Information

Practice Location

987400 Nebraska Medical Ctr, Omaha, NE 68198-1799

(402) 559-6637

(402) 559-8333

Mailing Location

988102 Nebraska Medical Ctr, Omaha, NE 68198-8102

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 638 Nebraska
Code 363AM0700X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 638 Nebraska

Provider Identifiers

ID	Description	Issuer
ID P00165113	Description Other	Issuer RR MCR

Randall Scott Lienemann

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Mccoy, Brittany

Grothe, Thomas John

Schneider, Carla J.

Determan, Daniel J

Gomez, Daisy

Alexander, Amanda

Ralston, Emma

Djidjoho, Marlene Ingrid

Schmitt, Ashley Lynn

Brittan, Jessica M