LAKE SUPERIOR COMMUNITY HEALTH CENTER
NPI 1699708297
Clinic/Center - Federally Qualified Health Center (FQHC) in Duluth, MN

Active since July 08, 2006
4325 GRAND AVE, DULUTH, MN 55807(218) 722-1497(218) 722-6239 Get Directions Write a Review

NPPES record last updated: February 13, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 10, 2023, Feb 3, 2022, Oct 15, 2021 and 2 more (5 updates tracked since 2020).

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 1699708297) is a healthcare organization registered as a federally qualified health center (fqhc) in Duluth, Minnesota and active in the NPI registry since July 2006. The organization lists Lee Homan, Ceo, as its authorized official.

NPPES Registry Identity

NPI1699708297
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameLAKE SUPERIOR COMMUNITY HEALTH CENTER
Location Address4325 GRAND AVEDuluth, MN 55807-2730
Mailing Address2222 E 5th StSuperior, WI 54880-3709 · (715) 392-1955 · Fax (715) 392-1935
Fax(218) 722-6239
Organization SubpartNo
Authorized OfficialLee HomanCeo · (715) 395-1955
Enumeration DateJuly 8, 2006
Last NPPES UpdateFebruary 13, 20245 updates tracked since enumeration
NPPES CertifiedFebruary 13, 2024
✔ NPI 1699708297 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
4325 GRAND AVE, Duluth, MN 55807

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

8

Medicare enrollment records show 8 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 8 within 10 miles. They are listed nearest first.

Clinicians, nearest first (8)

Nurse Practitioner
NPI 1417598079
4325 GRAND AVE
Duluth, MN 55807
(218) 722-1497
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1700854262
4325 GRAND AVE
Duluth, MN 55807
(218) 722-1497
✔ PECOS✔ Accepts MedicareSame address
Clinical Social Worker
NPI 1093293326
4325 GRAND AVE
Duluth, MN 55807
(218) 722-1497
✔ PECOS✔ Accepts MedicareSame address
Chiropractic
NPI 1699771337
4602 GRAND AVE STE 1000
Duluth, MN 55807
(218) 336-3520
✔ Accepts Medicare0.2 mi
Chiropractic
NPI 1255337937
4602 GRAND AVE STE 1000
Duluth, MN 55807
(218) 336-3520
✔ Accepts Medicare0.2 mi
Family Practice
NPI 1770551335
2222 E 5TH ST
Superior, WI 54880
(715) 392-1955
✔ PECOS✔ Accepts Medicare5.9 mi
Chiropractic
NPI 1487647723
2222 E 5TH ST
Superior, WI 54880
(715) 392-1955
✔ Accepts Medicare5.9 mi
Clinical Social Worker
NPI 1629366968
2222 E 5TH ST
Superior, WI 54880
(715) 392-1955
✔ PECOS✔ Accepts Medicare5.9 mi

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 1699708297. It was assigned to this organization in the NPPES registry on July 8, 2006.

Where is Lake Superior Community Health Center located?

Lake Superior Community Health Center is located at 4325 Grand Ave, Duluth, MN 55807. The listed phone number is (218) 722-1497.

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), 8 clinicians in 4 Medicare specialties reassign their Medicare billing to Lake Superior Community Health Center. 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. The largest specialties are Chiropractic (3), Clinical Social Worker (2) and Family Practice (2). Of these, 3 practice at this address and 8 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 HealthPartners 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.