NPIMap

Community Council of Idaho, Inc.

A Medicare group practice based in Blackfoot, ID: 4 NPIs enrolled under one PECOS associate control ID (PAC ID 6204877467), with 21 clinicians.

Medicare enrollment

Medicare enrollment files
PAC ID
6204877467The PECOS associate control ID: one enrolled organization, which may hold several NPIs
Provider type
Part A Provider - Federally Qualified Health Center (FQHC), Part B Supplier - Clinic/Group Practice
Enrolled in
ID
Enrollments
4
Group size
18 cliniciansAs Care Compare reports it
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Practice locations
6In 3 places

Enrollment records 4

Enrollment IDStateProvider typeNPI
O20051019000192 ID Part A Provider - Federally Qualified Health Center (FQHC) 1356416861
O20051019000183 ID Part A Provider - Federally Qualified Health Center (FQHC) 1710925250
O20050627001149 ID Part B Supplier - Clinic/Group Practice 1710925250
O20240705000969 ID Part A Provider - Federally Qualified Health Center (FQHC) 1710664834

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 21

Clinicians who reassign their Medicare benefits to this group (19) or whom Care Compare lists as members (18).

Sources for this page