CHI Health Pharmacy-Lakeside – Community/Retail Pharmacy, NPI 1780753632

CHI Health Pharmacy-Lakeside is a healthcare provider. based in Omaha, Nebraska. specializing in Community/Retail Pharmacy. The organization holds a License No. 2661 (NE). The NPI Number for CHI Health Pharmacy-Lakeside is 1780753632

Main info

Organization
Name
CHI Health Pharmacy-Lakeside
NPI
1780753632
Phone
(402) 758-5006
Address
16909 LAKESIDE HILLS CT
Authorized Official
MATTHEW HAZEN DIRECTOR
Enumeration Date
7 November 2006
Last Update Date
27 April 2017
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness80
Years active:19State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for CHI Health Pharmacy-Lakeside

  • Medical Office Building One, 16909, Lakeside Hills Court, Millard, Omaha, Douglas County, Nebraska, 68130, United States

    STE 107

    OMAHA, NE 681304664

    Phone: (402) 758-5006

    Fax: (402) 758-5094

    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)

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: 2016-11-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2025-06-30 (345 days ago).

Enrollment records

1

Earliest due date

2025-06-30

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
O20161122002233OPharmacyNE2025-06-30

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.

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 68130)

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Reviews

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Frequently asked questions

How do I look up CHI Health Pharmacy-Lakeside by NPI?
Use NPI 1780753632 when you need to reference CHI Health Pharmacy-Lakeside in forms, claims, or directories.
Is CHI Health Pharmacy-Lakeside's NPI currently valid?
The extract we use shows CHI Health Pharmacy-Lakeside as active.
Does CHI Health Pharmacy-Lakeside list a primary specialty?
If you are matching referrals, note Community/Retail Pharmacy for CHI Health Pharmacy-Lakeside. Clinical services aligned with this taxonomy classification.
What location shows for CHI Health Pharmacy-Lakeside?
We surface Omaha, Nebraska for CHI Health Pharmacy-Lakeside based on available NPPES addresses.
What if Omaha, Nebraska seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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