NPIMap

State of New Mexico

A Medicare group practice based in Roswell, NM: 5 NPIs enrolled under one PECOS associate control ID (PAC ID 1052210689), with 6 clinicians.

Medicare enrollment

Medicare enrollment files
PAC ID
1052210689The PECOS associate control ID: one enrolled organization, which may hold several NPIs
Provider type
Part A Provider - Hospital, Part A Provider - Skilled Nursing Facility, Part B Supplier - Clinic/Group Practice, Part B Supplier - Mass Immunization (Roster Biller Only)
Enrolled in
NM, TX
Enrollments
5
Group size
2 cliniciansAs Care Compare reports it
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Practice locations
8In 6 places

Enrollment records 5

Enrollment IDStateProvider typeNPI
O20040102000676 TX Part A Provider - Skilled Nursing Facility 1942287370
O20080304000905 NM Part A Provider - Skilled Nursing Facility 1982730669
O20100812000155 NM Part A Provider - Hospital 1922094770
O20110118000115 NM Part B Supplier - Clinic/Group Practice 1578730230
O20160906000790 NM Part B Supplier - Mass Immunization (Roster Biller Only) 1578609459

NPIs in this group 5

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 6

Clinicians who reassign their Medicare benefits to this group (6) or whom Care Compare lists as members (2).

Sources for this page