Provider Demographics
NPI:1104845148
Name:HINZE, MATHIEU LANE (MD)
Entity Type:Individual
Prefix:
First Name:MATHIEU
Middle Name:LANE
Last Name:HINZE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 LUCILE DR STE 103
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-4211
Mailing Address - Country:US
Mailing Address - Phone:402-483-2572
Mailing Address - Fax:402-483-2619
Practice Address - Street 1:4400 LUCILE DR STE 103
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-4211
Practice Address - Country:US
Practice Address - Phone:402-483-2572
Practice Address - Fax:402-483-2619
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE15894208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1013936012Medicaid
P00230083OtherRR MEDICARE PERFORMING #
1300171OtherUNITED HEALTH CARE
NE47066039913Medicaid
07373OtherBLUE CROSS BLUE SHIELD
247054OtherMIDLANDS CHOICE PPO
CG2908OtherRAILROAD MEDICARE GROUP #
099719Medicare ID - Type UnspecifiedGROUP #
NE47066039913Medicaid