Prairie Band Potawatomi Nation
A Medicare group practice based in Mayetta, KS: 2 NPIs enrolled under one PECOS associate control ID (PAC ID 7719921907), with 7 clinicians.
Medicare enrollment
Medicare enrollment files- PAC ID
- 7719921907
- Provider type
- Part B Supplier - Ambulance Service Supplier, Part B Supplier - Clinic/Group Practice
- Enrolled in
- KS
- Enrollments
- 2
- Group size
- 5 clinicians
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Practice locations
- 2
Enrollment records 2
| Enrollment ID | State | Provider type | NPI |
|---|---|---|---|
| O20050617000992 | KS | Part B Supplier - Clinic/Group Practice | 1245266410 |
| O20120308000783 | KS | Part B Supplier - Ambulance Service Supplier | 1174577738 |
NPIs in this group 2
NPPES NPI RegistryThese NPI records belong to the same enrolled organization. Each has its own page.
-
Prairie Band Potawatomi Nation
dba Potawatomi Tribal Fire Department
- Land Ambulance
- Mayetta, KS
- NPI 1174577738
-
Prairie Band Potawatomi Nation
dba Prairie Band Potawatomi Health Center
- Federally Qualified Health Center (FQHC)
- Mayetta, KS
- NPI 1245266410
Practice locations
- Mayetta, KS2
Clinicians 7
Clinicians who reassign their Medicare benefits to this group (7) or whom Care Compare lists as members (5).
-
Emily A Caudle, APRN
- Nurse Practitioner
- Topeka, KS
- NPI 1396091153
-
Nicholas J Eilert, APRN
- Nurse Practitioner
- Mayetta, KS
- NPI 1538696570
-
Abra Friess, APRN
- Nurse Practitioner
- Mayetta, KS
- NPI 1083095996
-
Jamie Mulanax Jacobsen, D.O.
- Family Medicine Physician
- Mayetta, KS
- NPI 1669447330
-
Karan Dawn Russell, APRN
- Psychiatric/Mental Health Nurse Practitioner
- Mayetta, KS
- NPI 1932524261
-
Thierry Tchekambou Tchiengue, MD
- Family Medicine Physician
- Mayetta, KS
- NPI 1669122404
-
Rochelle Virginia Vale, DO
- Family Medicine Physician
- Topeka, KS
- NPI 1750552154
Sources for this page
- Medicare Fee-For-Service Public Provider Enrollment: the enrollments, PAC ID, practice locations and benefit reassignments.
- Care Compare Doctors and Clinicians: group membership, group size and the name CMS shows patients.
- NPPES NPI Registry: the names and addresses of the NPIs above.