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
7719921907The PECOS associate control ID: one enrolled organization, which may hold several NPIs
Provider type
Part B Supplier - Ambulance Service Supplier, Part B Supplier - Clinic/Group Practice
Enrolled in
KS
Enrollments
2
Group size
5 cliniciansAs Care Compare reports it
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Practice locations
2In 1 place

Enrollment records 2

Enrollment IDStateProvider typeNPI
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 Registry

These NPI records belong to the same enrolled organization. Each has its own page.

Practice locations

Locations on the Medicare enrollment

Clinicians 7

Clinicians who reassign their Medicare benefits to this group (7) or whom Care Compare lists as members (5).

Sources for this page