NPIMap

Ponderosa Family Care LLC

A Medicare group practice based in Payson, AZ: 2 NPIs enrolled under one PECOS associate control ID (PAC ID 1456548015), with 14 clinicians.

Medicare enrollment

Medicare enrollment files
PAC ID
1456548015The PECOS associate control ID: one enrolled organization, which may hold several NPIs
Provider type
DME Supplier - Physician - Internal Medicine, Part A Provider - Rural Health Clinic, Part B Supplier - Clinic/Group Practice
Enrolled in
AZ
Enrollments
3
Group size
12 cliniciansAs Care Compare reports it
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Practice locations
4In 1 place

Enrollment records 3

Enrollment IDStateProvider typeNPI
O20101208000388 AZ Part B Supplier - Clinic/Group Practice 1144535626
O20200820002361 AZ Part A Provider - Rural Health Clinic 1992321723
O20191025001189 AZ DME Supplier - Physician - Internal Medicine 1144535626

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 14

Clinicians who reassign their Medicare benefits to this group (14) or whom Care Compare lists as members (12).

Sources for this page