NPIMap

De Baca Family Practice Clinic

A Medicare group practice based in Fort Sumner, NM: 4 NPIs enrolled under one PECOS associate control ID (PAC ID 6406758358), with 6 clinicians.

Medicare enrollment

Medicare enrollment files
PAC ID
6406758358The 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
NM
Enrollments
3
Group size
3 cliniciansAs Care Compare reports it
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Practice locations
4In 1 place

Enrollment records 3

Enrollment IDStateProvider typeNPI
O20040122000409 NM Part B Supplier - Clinic/Group Practice 1003855032
O20060621000067 NM Part A Provider - Federally Qualified Health Center (FQHC) 1003855032
O20180212002394 NM Part A Provider - Federally Qualified Health Center (FQHC) 1699082644

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 6

Clinicians who reassign their Medicare benefits to this group (5) or whom Care Compare lists as members (3).

Sources for this page