NPIMap

The Fort Defiance Indian Hospital Board, Incorporation

A Medicare group practice based in Fort Defiance, AZ: 2 NPIs enrolled under one PECOS associate control ID (PAC ID 0941336697), with 520 clinicians.

Medicare enrollment

Medicare enrollment files
PAC ID
0941336697The PECOS associate control ID: one enrolled organization, which may hold several NPIs
Provider type
Part A Provider - Indian Health Services Facility, Part B Supplier - Ambulatory Surgical Center, Part B Supplier - Clinic/Group Practice
Enrolled in
AZ, TX
Enrollments
3
Group size
153 cliniciansAs Care Compare reports it
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Practice locations
6In 3 places

Enrollment records 3

Enrollment IDStateProvider typeNPI
O20100416000146 TX Part B Supplier - Ambulatory Surgical Center 1487977914
O20100429001153 TX Part B Supplier - Clinic/Group Practice 1477876639
O20210526003128 AZ Part A Provider - Indian Health Services Facility 1477876639

NPIs in this group 2

NPPES NPI Registry

These NPI records belong to the same enrolled organization. Each has its own page.

Practice locations

Locations on the Medicare enrollment

Clinicians 520

Page 1 of 6

Clinicians who reassign their Medicare benefits to this group (520) or whom Care Compare lists as members (153).

Sources for this page