Dr Keith C Leatherbury, MD is a medicare enrolled "Surgery" physician in Fremont, Nebraska. He graduated from medical school in 1987 and has 37 years of diverse experience with area of expertise as General Surgery. He is a member of the group practice Physicians Clinic Inc and his current practice location is
2830 N Clarkson St, Fremont, Nebraska. You can reach out to his office (for appointments etc.) via phone at
(402) 721-6333.
Dr Keith C Leatherbury is licensed to practice in Nebraska (license number 18655) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1780682153.
Physician's Profile
Full Name | Dr Keith C Leatherbury |
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Gender | Male |
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Speciality | General Surgery |
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Experience | 37 Years |
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Location | 2830 N Clarkson St, Fremont, Nebraska |
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Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Dr Keith C Leatherbury graduated from medical school in 1987
NPI Data:
- NPI Number: 1780682153
- Provider Enumeration Date: 07/11/2005
- Last Update Date: 09/03/2021
Medicare PECOS Information:
- PECOS PAC ID: 6002903531
- Enrollment ID: I20100716000015
Medical Identifiers
Medical identifiers for Dr Keith C Leatherbury such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1780682153 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208600000X | Surgery | 18655 (Nebraska) | Primary |
174400000X | Specialist | 18655 (Nebraska) | Secondary |
Medical Facilities Affiliation
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Physicians Clinic Inc | 4880506062 | 505 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Keith C Leatherbury allows following entities to bill medicare on his behalf.
Entity Name | Physicians Clinic Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1821049156 PECOS PAC ID: 4880506062 Enrollment ID: O20031105000345 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Keith C Leatherbury is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Keith C Leatherbury, MD 2830 N Clarkson St, Fremont, NE 68025-7718 Ph: (402) 721-6333 | Dr Keith C Leatherbury, MD 2830 N Clarkson St, Fremont, NE 68025-7718 Ph: (402) 721-6333 |
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