NPIMap

Southlake Community Mental Health Center Inc

A Medicare group practice based in Hammond, IN: 12 NPIs enrolled under one PECOS associate control ID (PAC ID 5991600355), with 89 clinicians.

Medicare enrollment

Medicare enrollment files
PAC ID
5991600355The PECOS associate control ID: one enrolled organization, which may hold several NPIs
Provider type
Part A Provider - Federally Qualified Health Center (FQHC), Part A Provider - Hospital, Part B Supplier - Clinic/Group Practice
Enrolled in
IN
Enrollments
9
Group size
37 cliniciansAs Care Compare reports it
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Practice locations
40In 5 places

Enrollment records 9

Enrollment IDStateProvider typeNPI
O20031201000049 IN Part B Supplier - Clinic/Group Practice 1821081290
O20031231000117 IN Part B Supplier - Clinic/Group Practice 1821081290
O20040513000199 IN Part B Supplier - Clinic/Group Practice 1821081290
O20150921001324 IN Part A Provider - Federally Qualified Health Center (FQHC) 1376919217
O20160318001142 IN Part A Provider - Federally Qualified Health Center (FQHC) 1609231927
O20130220000286 IN Part A Provider - Hospital 1548407216
O20131230001121 IN Part A Provider - Federally Qualified Health Center (FQHC) 1134543960
O20170726002650 IN Part A Provider - Federally Qualified Health Center (FQHC) 1477007292
O20140219001510 IN Part A Provider - Federally Qualified Health Center (FQHC) 1508297540

NPIs in this group 12

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 89

Clinicians who reassign their Medicare benefits to this group (89) or whom Care Compare lists as members (37).

Sources for this page