NPIMap

Pinelake Physician Practice LLC

A Medicare group practice based in Mayfield, KY: 13 NPIs enrolled under one PECOS associate control ID (PAC ID 6800797507), with 71 clinicians.

Medicare enrollment

Medicare enrollment files
PAC ID
6800797507The PECOS associate control ID: one enrolled organization, which may hold several NPIs
Provider type
DME Supplier - Physician - Podiatry, Part A Provider - Rural Health Clinic, Part B Supplier - Clinic/Group Practice
Enrolled in
KY
Enrollments
9
Group size
45 cliniciansAs Care Compare reports it
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Practice locations
23In 6 places

Enrollment records 9

Enrollment IDStateProvider typeNPI
O20040115001094 KY Part B Supplier - Clinic/Group Practice 1295960532
O20150213000657 KY DME Supplier - Physician - Podiatry 1861563439
O20170721003041 KY Part A Provider - Rural Health Clinic 1437623337
O20140205000338 KY Part A Provider - Rural Health Clinic 1295960532
O20160525000413 KY Part A Provider - Rural Health Clinic 1205494085
O20210428000985 KY Part A Provider - Rural Health Clinic 1922645134
O20210514000883 KY Part A Provider - Rural Health Clinic 1437614633
O20250819003484 KY Part A Provider - Rural Health Clinic 1093609612
O20230125002844 KY Part A Provider - Rural Health Clinic 1841900347

NPIs in this group 13

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 71

Clinicians who reassign their Medicare benefits to this group (71) or whom Care Compare lists as members (45).

Sources for this page