WAVERLY HEALTH CARE URGENT CARE
NPI 1780814475
Family Medicine in Waverly, NE
About Waverly Health Care Urgent Care NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WAVERLY HEALTH CARE URGENT CARE (NPI 1780814475) is a healthcare organization registered as a family medicine in Waverly, Nebraska and active in the NPI registry since July 2009. The organization holds a CLIA Waiver certificate valid through June 6, 2028 and lists Matthew M Glenn, Physician, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Other Names 1
Other Identifiers 1
Group Practice 1
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)
Waverly Health Care Urgent Care 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 Waverly Health Care Urgent Care, which bills Medicare for the services they deliver. Of these, 4 practice 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.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 28D1099228
Waverly Health Care Urgent Care · Waverly, NEFrequently 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 Pine Lake Health LLC's NPI number?
The NPI number for Pine Lake Health LLC is 1780814475. It was assigned to this organization in the NPPES registry on July 16, 2009. The provider is doing business as Waverly Health Care Urgent Care.
Where is Pine Lake Health LLC located?
Pine Lake Health LLC is located at 13220 Callum Dr Ste 4, Waverly, NE 68462. The listed phone number is (402) 786-5563.
What is Pine Lake Health LLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Pine Lake Health LLC enrolled in Medicare?
Yes. Pine Lake Health LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Pine Lake Health LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 2 Medicare specialties reassign their Medicare billing to Pine Lake Health 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. The largest specialties are Nurse Practitioner (5) and Family Practice (1). Of these, 4 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Pine Lake Health LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 28D1099228) is associated with this NPI, valid through June 6, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Pine Lake Health LLC accept?
Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Sunflower Health Plan and Oscar Insurance Company list Pine Lake Health 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 Pine Lake Health LLC was last updated on August 30, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Waverly Health Care Urgent Care · NPI 1780814475
Family Medicine organization in Waverly, Nebraska. Organization record, active in the CMS NPPES registry since July 16, 2009.
## Identity
- **NPI:** 1780814475 (Entity type: Organization)
- **Enumerated:** July 16, 2009
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Pine Lake Health Llc
- **Organization subpart:** Yes (part of Pine Lake Health, Llc)
- **Authorized official:** Matthew Glenn, PHYSICIAN
## Practice location
- **Address:** 13220 CALLUM DR, STE 4, Waverly, NE 68462-2561
- **Phone:** (402) 786-5563 · **Fax:** (402) 423-4201
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 6 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (5), Family Practice (1); 4 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 30, 2022
- **Other identifiers:** Medicaid 10025748100 (NE)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1780814475) · Data from the CMS NPPES public registry.