Fred LeRoy Health & Wellness Center – Clinic/Center, NPI 1710172879
Clinic/Center
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Fred LeRoy Health & Wellness Center
1800 Syracuse Ave
Norfolk, NE 687012458
Phone: (402) 371-8780
Fax: (402) 379-4293
Type: Location
125 6th St
Sioux City, IA 511034405
Phone: (712) 258-0500
Fax: (712) 258-0762
Type: Location
1701 E St
Lincoln, NE 685083429
Phone: (402) 438-9222
Fax: (402) 438-9226
Type: Location
2528 Woodbine St
Niobrara, NE 687606111
Phone: (402) 857-3391
Fax: (402) 857-3736
Type: Location
5805, South 86th Circle, Omaha, Douglas County, Nebraska, 68127, United States
OMAHA, NE 681274145
Phone: (402) 315-2760
Type: Mailing
Fred LeRoy Health and Wellness Center, 2602, J Street, South Omaha, Omaha, Douglas County, Nebraska, 68107, United States
OMAHA, NE 681071643
Phone: (402) 733-3612
Fax: (402) 734-7156
Type: Location
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: 2023-03-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-03-31 (802 days ago).
Enrollment records
4
Earliest due date
2024-03-31
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 |
|---|---|---|---|---|
| O20190227000629 | O | Federally Qualified Health Center (Fqhc) | NE | 2024-03-31 |
| O20190311001784 | O | Clinic/Group Practice | TX | 2024-05-31 |
| O20190626003270 | O | Federally Qualified Health Center (Fqhc) | TX | 2024-06-30 |
| O20230307003192 | O | Federally Qualified Health Center (Fqhc) | TX | TBD |
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 68701)
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