NPIMap

Madison County

A Medicare group practice based in Wampsville, NY: 2 NPIs enrolled under one PECOS associate control ID (PAC ID 2365335957), with 18 clinicians.

Medicare enrollment

Medicare enrollment files
PAC ID
2365335957The PECOS associate control ID: one enrolled organization, which may hold several NPIs
Provider type
Part B Supplier - Clinic/Group Practice, Part B Supplier - Mass Immunization (Roster Biller Only)
Enrolled in
NY
Enrollments
2
Group size
11 cliniciansAs Care Compare reports it
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Practice locations
2In 1 place

Enrollment records 2

Enrollment IDStateProvider typeNPI
O20040206000289 NY Part B Supplier - Clinic/Group Practice 1689780546
O20120319000307 NY Part B Supplier - Mass Immunization (Roster Biller Only) 1487796975

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 18

Clinicians who reassign their Medicare benefits to this group (18) or whom Care Compare lists as members (11).

Sources for this page