Individual provider Active NPI

Leland Carl Zlomke, PH.D.

  • Psychologist
  • Beatrice, NE
National Provider Identifier
1164446605
Registry record updated Apr 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
110 N 9TH St
Beatrice, NE 68310-4009
Phone
(402) 483-6990
Fax
(402) 483-7045
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary
Forensic Psychologist 103TF0200X
Intellectual & Developmental Disabilities Psychologist 103TM1800X
Cognitive & Behavioral Psychologist 103TB0200X
Counseling Psychologist 103TC1900X
Clinical Child & Adolescent Psychologist 103TC2200X

Addresses

Primary practice location

110 N 9TH St
Beatrice, NE 68310-4009

Mailing address

5321 S 78TH St
Lincoln, NE 68516-6356
Phone (402) 806-1700

Other practice location 1

4545 S 86th St
Lincoln, NE 68526-9227
Phone (402) 483-6990

Other identifiers 4

IdentifierTypeStateIssuer
245672OtherNEMIDLANDS CHOICE
P00963834OtherNEMEDICARE RAILROAD
49038OtherNEBCBS
90095OtherNEBCBS AUXILLARY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040520000255 NE Practitioner - Clinical Psychologist 4385635275 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Nebraska College of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Silver Sun Mental HealthGroup PAC ID 4082885793, 9 clinicians

Practice addresses (Care Compare)

4545 S 86TH St
Lincoln, NE 68526-9262
Phone (402) 483-6990

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
244NEMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Sun Mental Health CurrentSince Sep 1, 2011 Accepting new patients

Locations

110 N 9th St
Beatrice, NE 68310
Phone (402) 483-6990

500 Market St
Beatrice, NE 68310
Phone (402) 474-3955

4545 S 86th St
Lincoln, NE 68526
Phone (402) 483-6990

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586822400000",
    "number": "1164446605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5321 S 78TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685166356",
            "telephone_number": "402-806-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N 9TH ST",
            "city": "BEATRICE",
            "state": "NE",
            "postal_code": "683104009",
            "telephone_number": "402-483-6990",
            "fax_number": "402-483-7045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4545 S 86th St",
            "address_purpose": "LOCATION",
            "city": "Lincoln",
            "state": "NE",
            "postal_code": "685269227",
            "country_code": "US",
            "telephone_number": "402-483-6990",
            "fax_number": "402-483-7045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZLOMKE",
        "first_name": "LELAND",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "245672",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00963834",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "49038",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS AUXILLARY",
            "identifier": "90095",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beatrice, NE

Sources for this page

Verify at the official NPI Registry.