MED PLAZA – Federally Qualified Health Center (FQHC), NPI 1750769238

MED PLAZA is a healthcare provider. based in Longview, Texas. specializing in Federally Qualified Health Center (FQHC). The NPI Number for MED PLAZA is 1750769238

Main info

Organization
Name
MED PLAZA
NPI
1750769238
Phone
(903) 234-0776
Address
PO BOX 2709
Authorized Official
MR. KIM NESVIG EXECUTIVE DIRECTOR
Enumeration Date
15 May 2015
Last Update Date
20 January 2023
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness80
Years active:11State licenses:0Digital endpointsUpdated within 12 months

Provider Addresses for MED PLAZA

  • PO BOX 2709

    LONGVIEW, TX 756062709

    Phone: (903) 234-0776

    Fax: (903) 234-9769

    Type: Mailing

  • 703 E MARSHALL AVE

    SUITE 310

    LONGVIEW, TX 756015500

    Phone: (603) 234-8611

    Fax: (903) 758-2283

    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: 2015-09-08

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
O20150908001240OFederally Qualified Health Center (Fqhc)TXTBD

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.

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

Insurance plans in this area (ZIP 75606)

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Reviews

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Frequently asked questions

Is there an official ID for MED PLAZA in U.S. healthcare records?
The official identifier for MED PLAZA is NPI 1750769238.
Is MED PLAZA still an active registrant?
MED PLAZA carries an active NPI according to the public dataset.
What expertise is attributed to MED PLAZA?
MED PLAZA's specialty line reads Federally Qualified Health Center (FQHC). Clinical services aligned with this taxonomy classification.
Is MED PLAZA associated with Longview?
Public fields place MED PLAZA around Longview, Texas. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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