NPIMap

Lake Superior Community Health Center

A Medicare group practice based in Duluth, MN: 4 NPIs enrolled under one PECOS associate control ID (PAC ID 6608810031), with 11 clinicians.

Medicare enrollment

Medicare enrollment files
PAC ID
6608810031The 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
MN, WI
Enrollments
5
Group size
11 cliniciansAs Care Compare reports it
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Practice locations
7In 3 places

Enrollment records 5

Enrollment IDStateProvider typeNPI
O20050615001058 MN Part A Provider - Federally Qualified Health Center (FQHC) 1699708297
O20211019001959 WI Part A Provider - Federally Qualified Health Center (FQHC) 1063789022
O20211111000032 MN Part A Provider - Federally Qualified Health Center (FQHC) 1760013700
O20100928000963 MN Part B Supplier - Clinic/Group Practice 1699708297
O20110205000134 WI Part B Supplier - Clinic/Group Practice 1063789022

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 11

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

Sources for this page