NPIMap

Black Canyon Community Health Center Inc.

A Medicare group practice based in Mayer, AZ: 3 NPIs enrolled under one PECOS associate control ID (PAC ID 6406900331), with 8 clinicians.

Medicare enrollment

Medicare enrollment files
PAC ID
6406900331The 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
AZ
Enrollments
3
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 3

Enrollment IDStateProvider typeNPI
O20090812000350 AZ Part B Supplier - Clinic/Group Practice 1679723217
O20220805002436 AZ Part A Provider - Federally Qualified Health Center (FQHC) 1992438642
O20230601002988 AZ Part A Provider - Federally Qualified Health Center (FQHC) 1124730627

NPIs in this group 3

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 8

Clinicians who reassign their Medicare benefits to this group (8) or whom Care Compare lists as members (4).

Sources for this page