LAKE SUPERIOR COMMUNITY HEALTH CENTER
NPI 1063789022
Clinic/Center - Federally Qualified Health Center (FQHC) in Superior, WI
About Lake Superior Community Health Center NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LAKE SUPERIOR COMMUNITY HEALTH CENTER (NPI 1063789022) is a healthcare organization registered as a federally qualified health center (fqhc) in Superior, Wisconsin and active in the NPI registry since November 2011. The organization lists Lee Homan, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Lake Superior Community Health Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
6Medicare enrollment records show 6 clinicians reassign Medicare billing to Lake Superior Community Health Center, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 6 within 10 miles. They are listed nearest first.
Clinicians, nearest first (6)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Lake Superior Community Health Center's NPI number?
The NPI number for Lake Superior Community Health Center is 1063789022. It was assigned to this organization in the NPPES registry on November 18, 2011.
Where is Lake Superior Community Health Center located?
Lake Superior Community Health Center is located at 2222 E 5th St, Superior, WI 54880. The listed phone number is (715) 392-1955.
What is Lake Superior Community Health Center's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.
Is Lake Superior Community Health Center enrolled in Medicare?
Yes. Lake Superior Community Health Center is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Lake Superior Community Health Center?
According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians reassign their Medicare billing to Lake Superior Community Health Center, in Chiropractic, Clinical Social Worker, Family Practice and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 3 practice at this address and 6 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Lake Superior Community Health Center accept?
Health plans from Anthem Blue Cross and Blue Shield, HealthPartners and Security Health Plan list Lake Superior Community Health Center as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Lake Superior Community Health Center was last updated on February 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Lake Superior Community Health Center · NPI 1063789022
Federally Qualified Health Center (FQHC) organization in Superior, Wisconsin. Organization record, active in the CMS NPPES registry since November 18, 2011.
## Identity
- **NPI:** 1063789022 (Entity type: Organization)
- **Enumerated:** November 18, 2011
- **Primary specialty:** Clinic/Center - Federally Qualified Health Center (FQHC) · taxonomy 261QF0400X
- **Organization subpart:** No
- **Authorized official:** Lee Homan, CEO
## Practice location
- **Address:** 2222 E 5TH ST, Superior, WI 54880-3709
- **Phone:** (715) 392-1955 · **Fax:** (715) 392-1935
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 6 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Clinical Social Worker (2), Family Practice (2), Chiropractic (1); 3 practice at this address and 6 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 13, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1063789022) · Data from the CMS NPPES public registry.