PROFESSIONAL PROVIDER ENTERPRISE LLC
NPI 1770852196
Optometrist in Omaha, NE
About Professional Provider Enterprise Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PROFESSIONAL PROVIDER ENTERPRISE LLC (NPI 1770852196) is a healthcare organization registered as an optometrist in Omaha, Nebraska and active in the NPI registry since December 2011. The organization lists John Rosenbaum, Cco, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
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)
Professional Provider Enterprise Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date 3
Next revalidation due by January 31, 2027
This provider holds 3 Medicare enrollments with upcoming revalidation dates. 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
15Medicare enrollment records show 15 clinicians reassign Medicare billing to Professional Provider Enterprise LLC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (15)
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 Professional Provider Enterprise LLC's NPI number?
The NPI number for Professional Provider Enterprise LLC is 1770852196. It was assigned to this organization in the NPPES registry on December 14, 2011.
Where is Professional Provider Enterprise LLC located?
Professional Provider Enterprise LLC is located at 10826 Old Mill Rd Ste 101, Omaha, NE 68154. The listed phone number is (402) 898-3232.
What is Professional Provider Enterprise LLC's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Professional Provider Enterprise LLC enrolled in Medicare?
Yes. Professional Provider Enterprise LLC is registered in the Medicare PECOS enrollment system.
When is Professional Provider Enterprise LLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), Professional Provider Enterprise LLC holds 3 Medicare enrollments with upcoming revalidation dates. The next is due by January 31, 2027 (Non-DME Part B, Oregon, Clinic/Group Practice). 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 Professional Provider Enterprise LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 15 clinicians, all in Optometry, reassign their Medicare billing to Professional Provider Enterprise LLC. 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, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Professional Provider Enterprise LLC accept?
Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan and Anthem Blue Cross and Blue Shield and 5 other insurers list Professional Provider Enterprise LLC 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 Professional Provider Enterprise LLC was last updated on August 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Professional Provider Enterprise Llc · NPI 1770852196
Optometrist organization in Omaha, Nebraska. Organization record, active in the CMS NPPES registry since December 14, 2011.
## Identity
- **NPI:** 1770852196 (Entity type: Organization)
- **Enumerated:** December 14, 2011
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **Organization subpart:** No
- **Authorized official:** John Rosenbaum, CCO
## Practice location
- **Address:** 10826 OLD MILL RD STE 101, Omaha, NE 68154-2660
- **Phone:** (402) 898-3232 · **Fax:** (402) 898-3234
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (Non-DME Part B, Oregon, Clinic/Group Practice), next of 3 enrollments with upcoming dates · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 15 clinicians (Optometry) reassign Medicare billing to this organization (form CMS-855R); 1 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 22, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1770852196) · Data from the CMS NPPES public registry.