NPIMap

Port Gamble S'Klallam Tribe

A Medicare group practice based in Kingston, WA: 2 NPIs enrolled under one PECOS associate control ID (PAC ID 6204737927), with 31 clinicians.

Medicare enrollment

Medicare enrollment files
PAC ID
6204737927The PECOS associate control ID: one enrolled organization, which may hold several NPIs
Provider type
DME Supplier - Pharmacy, Part A Provider - Federally Qualified Health Center (FQHC), Part B Supplier - Clinic/Group Practice
Enrolled in
WA
Enrollments
3
Group size
11 cliniciansAs Care Compare reports it
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Practice locations
3In 1 place

Enrollment records 3

Enrollment IDStateProvider typeNPI
O20040115001158 WA Part B Supplier - Clinic/Group Practice 1760428650
O20260604000775 WA DME Supplier - Pharmacy 1922970458
O20100827000443 WA Part A Provider - Federally Qualified Health Center (FQHC) 1760428650

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 31

Clinicians who reassign their Medicare benefits to this group (25) or whom Care Compare lists as members (11).

Sources for this page