NPIMap

Mountain West Derm - Blackhart PLLC

A Medicare group practice based in Reno, NV: 9 NPIs enrolled under one PECOS associate control ID (PAC ID 1153609813), with 141 clinicians.

Medicare enrollment

Medicare enrollment files
PAC ID
1153609813The PECOS associate control ID: one enrolled organization, which may hold several NPIs
Provider type
Part B Supplier - Ambulatory Surgical Center, Part B Supplier - Clinic/Group Practice
Enrolled in
AK, ID, NV, OR, TX, WA
Enrollments
8
Group size
103 cliniciansAs Care Compare reports it
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Practice locations
40In 28 places

Enrollment records 8

Enrollment IDStateProvider typeNPI
O20161031002278 NV Part B Supplier - Clinic/Group Practice 1740633015
O20171219002516 OR Part B Supplier - Clinic/Group Practice 1447764741
O20191023002754 AK Part B Supplier - Clinic/Group Practice 1124670088
O20211018000436 TX Part B Supplier - Clinic/Group Practice 1366018848
O20200904001722 WA Part B Supplier - Clinic/Group Practice 1013557933
O20200319000475 ID Part B Supplier - Ambulatory Surgical Center 1619517539
O20200324001980 WA Part B Supplier - Ambulatory Surgical Center 1619517539
O20180808001264 ID Part B Supplier - Clinic/Group Practice 1548758501

NPIs in this group 9

NPPES NPI Registry

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

Practice locations

Locations on the Medicare enrollment

Merit-based Incentive Payment System (MIPS)

Medicare Care Compare
Final score
75 of 100Reported as group, on the record of 75 clinicians in this group

Clinicians 141

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Clinicians who reassign their Medicare benefits to this group (141) or whom Care Compare lists as members (103).

Sources for this page