NORTHEAST COMMUNITY CLINIC
NPI 1700097540
Clinic/Center - Federally Qualified Health Center (FQHC) in Wilmington, CA
About Northeast Community Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NORTHEAST COMMUNITY CLINIC (NPI 1700097540), doing business as Wilmington Family Health Center, is a healthcare organization registered as a federally qualified health center (fqhc) in Wilmington, California and active in the NPI registry since May 2007. The organization lists Christopher Tak Lau, Executive Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Northeast Community Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
45Medicare enrollment records show 45 clinicians reassign Medicare billing to Northeast Community Clinic, which bills Medicare for the services they deliver. Of these, 7 practice at this address and 10 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 9
Nearest to this location (20)
See all 45Source: 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 Northeast Community Clinic's NPI number?
The NPI number for Northeast Community Clinic is 1700097540. It was assigned to this organization in the NPPES registry on May 24, 2007. The provider is doing business as Wilmington Family Health Center.
Where is Northeast Community Clinic located?
Northeast Community Clinic is located at 200 E Anaheim St, Wilmington, CA 90744. The listed phone number is (310) 522-8700.
What is Northeast Community Clinic's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.
Is Northeast Community Clinic enrolled in Medicare?
Yes. Northeast Community Clinic is registered in the Medicare PECOS enrollment system.
When is Northeast Community Clinic's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (California, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Northeast Community Clinic?
According to the CMS Revalidation Reassignment List (October 2026 release), 45 clinicians in 9 Medicare specialties reassign their Medicare billing to Northeast Community Clinic. 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 Family Practice (11), Pediatric Medicine (9) and Clinical Social Worker (6). Of these, 7 practice at this address and 10 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Northeast Community Clinic was last updated on July 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.
# Northeast Community Clinic · NPI 1700097540
Federally Qualified Health Center (FQHC) organization in Wilmington, California. Organization record, active in the CMS NPPES registry since May 24, 2007.
## Identity
- **NPI:** 1700097540 (Entity type: Organization)
- **Enumerated:** May 24, 2007
- **Primary specialty:** Clinic/Center - Federally Qualified Health Center (FQHC) · taxonomy 261QF0400X
- **Also known as:** Wilmington Family Health Center (Doing Business As)
- **Organization subpart:** Yes (part of Northeast Community Clinic)
- **Authorized official:** Christopher Lau, EXECUTIVE DIRECTOR
## Practice location
- **Address:** 200 E ANAHEIM ST, Wilmington, CA 90744
- **Phone:** (310) 522-8700
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, California, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 45 clinicians in 9 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (11), Pediatric Medicine (9), Clinical Social Worker (6); 7 practice at this address and 10 within 10 miles; [full list](https://npiprofile.com/npi/1700097540/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 24, 2026
- **Other identifiers:** Medicaid CMM71121F (CA)
---
Source: [NPI Profile](https://npiprofile.com/npi/1700097540) · Data from the CMS NPPES public registry.