Active NPI
Leo L Meduna, MD
- Family Medicine Physician
- Wahoo, NE
National Provider Identifier
1386608396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- NE18618
- Practice address
- 1760 County Road J
Saunders Medical Center
Wahoo, NE 68066-4152 - Phone
- (402) 443-4191
- Fax
- (402) 443-1440
- NPI assigned
- Apr 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 18618 | NE | |
| Family Medicine Physician | 207Q00000X | NE18618 | NE | Primary |
Addresses
Primary practice location
1760 County Road J
Saunders Medical Center
Wahoo, NE 68066-4152
Mailing address
1760 County Road J
Saunders Medical Center
Wahoo, NE 68066-4152
Phone (402) 443-4191
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 76070872013 | Medicaid | NE | |
| 099262 | Other | MEDICARE GROUP | |
| 080188771 | Other | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NE18618 | NE | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Healthcare of Wahoo, LLC | Family Medicine | Past | Accepting new patients |
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": "1144972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296086400000",
"number": "1386608396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1760 COUNTY ROAD J",
"address_2": "SAUNDERS MEDICAL CENTER",
"city": "WAHOO",
"state": "NE",
"postal_code": "680664152",
"telephone_number": "402-443-4191",
"fax_number": "402-443-1440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1760 COUNTY ROAD J",
"address_2": "SAUNDERS MEDICAL CENTER",
"city": "WAHOO",
"state": "NE",
"postal_code": "680664152",
"telephone_number": "402-443-4191",
"fax_number": "402-443-1440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDUNA",
"first_name": "LEO",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-14",
"last_updated": "2011-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NE",
"license": "18618",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NE",
"license": "NE18618",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "76070872013",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP",
"identifier": "099262",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "080188771",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Wahoo, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.