DR. KEITH C LEATHERBURY (MD) – Surgery Physician, NPI 1780682153

DR. KEITH C LEATHERBURY (MD) is a healthcare provider. based in Fremont, Nebraska. specializing in GENERAL SURGERY. They hold the professional credentials MD. They hold a License No. 18655 (NE). The NPI Number for DR. KEITH C LEATHERBURY (MD) is 1780682153

Main info

Male
39 Years Of Experience
Accepts Medicare Assignment
Name
DR. KEITH C LEATHERBURY (MD)
NPI
1780682153
Phone
(402) 721-6333
Address
2830 N CLARKSON ST
Enumeration Date
11 July 2005
Last Update Date
3 September 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4029785656
Graduation Year
1987 (39 years ago)
PAC ID
6002903531
Group Practice PAC ID
4880506062
Professional Enrollment ID
I20100716000015
Address ID
NE680252303FR450XXSTXX405
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience69
Completeness75
Years active:20State licenses:1Digital endpointsOther names

202 GENERAL SURGERY in NE

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Provider Addresses for DR. KEITH C LEATHERBURY (MD)

  • 2830, North Clarkson Street, Fremont, Dodge County, Nebraska, 68025, United States

    FREMONT, NE 680257718

    Phone: (402) 721-6333

    Fax: (402) 721-6320

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $68.

Total Amount is formed as General ($68) + Research ($0) + Ownership ($0) = $68.

Last reported payment date: 2024-12-06 • Largest payer in this snapshot: Smith+Nephew, Inc. ($39).

Total Amount

$68

General + Research + Ownership

Payments

3

Total payment records

General Amount

$68

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-06

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2010-07-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100716000015IGeneral SurgeryNETBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes262125$0
99203New patient office or other outpatient visit, 30-44 minutes5050$0
99212Established patient office or other outpatient visit, 10-19 minutes3632$0
11042Removal of skin and tissue, 20.0 sq cm or less3122$0
99204New patient office or other outpatient visit, 45-59 minutes2323$0
View full utilization report →

Insurance plans in this area (ZIP 68025)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4880506062View full group profile
NameSpecialtyState
-IA
N E U R O L O G YNE
Family Practice, HospitalistIA
Nurse PractitionerNE
Internal MedicineNE
O B S T E T R I C S/ G Y N E C O L O G YNE
Infectious DiseaseNE
-NE
O B S T E T R I C S/ G Y N E C O L O G YNH
Cardiovascular Disease (Cardiology), Internal MedicineNE

Reviews

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Frequently asked questions

What federal number belongs to DR. KEITH C LEATHERBURY (MD)?
The federal identifier for DR. KEITH C LEATHERBURY (MD) is NPI 1780682153.
Is DR. KEITH C LEATHERBURY (MD) currently active in the NPI registry?
CMS-published data lists DR. KEITH C LEATHERBURY (MD) as an active registrant.
What field does DR. KEITH C LEATHERBURY (MD) work in?
You can think of DR. KEITH C LEATHERBURY (MD) as practicing within Surgery Physician. Clinical services aligned with this taxonomy classification.
Does DR. KEITH C LEATHERBURY (MD) practice in Nebraska?
You will see Fremont, Nebraska on file for DR. KEITH C LEATHERBURY (MD) alongside any extra practice locations.
How can I contact DR. KEITH C LEATHERBURY (MD)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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