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A Medicare group practice based in Vancouver, WA: 4 NPIs enrolled under one PECOS associate control ID (PAC ID 2860758307), with 10 clinicians.

Medicare enrollment

Medicare enrollment files
PAC ID
2860758307The PECOS associate control ID: one enrolled organization, which may hold several NPIs
Provider type
Part B Supplier - Clinic/Group Practice
Enrolled in
WA
Enrollments
1
Group size
4 cliniciansAs Care Compare reports it
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Practice locations
4In 2 places

Enrollment records 1

Enrollment IDStateProvider typeNPI
O20171115003724 WA Part B Supplier - Clinic/Group Practice 1689892473

NPIs in this group 4

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 10

Clinicians who reassign their Medicare benefits to this group (10) or whom Care Compare lists as members (4).

Sources for this page