Christopher K Jentoft, M.D.
Individual provider Active NPI Family Medicine Physician · Whiteriver, AZ
NPI 1003040940 · NPPES record last updated Feb 11, 2016
Key facts
- NPI
- 1003040940
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 44352 (AZ)
- Practice address
- 200 West Hospital Drive
Whiteriver, AZ 85941-0860 - Phone
- (928) 338-4911
- Fax
- (928) 338-3520
- NPI assigned
- May 6, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Wayne State University School of Medicine, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- DHHS IHS Phoenix Area
Navajo Health Foundation-Sage Memorial Hospital, Inc.
Practice addresses (Care Compare)
200 W Hospital Dr
Whiteriver, AZ 85941-0860
Phone 92833849113532
N Cromwell Rd
Cibecue Health Ctr
Cebecue, AZ 85911-0037
Phone 92833849113532
PO Box
Suite 860
Whiteriver, AZ 85941-0860
State Hwy 264 JCT Hwy 191
Ganado, AZ 86505-0457
Phone 92875545004933
Hospital & facility affiliations
- Whiteriver PHS Indian Hospital
- Chinle Comprehensive Health Care Facility
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX, AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130126000003 | TX | Practitioner - Family Practice | 5698929750 | Reassigns benefits to 5 organizations |
| I20160212002440 | AZ | Practitioner - Family Practice |
5698929750 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DHHS PHS IHS Phoenix Area | Current |
Accepting new patients | |
| San Carlos Apache Healthcare Corporation | Current |
Accepting new patients | |
| DHHS IHS Phoenix Area | Current |
Accepting new patients | |
| DHHS IHS Phoenix Area | Current |
Accepting new patients | |
| Hospitalist Medicine Healthcare LLC | Current |
Accepting new patients | |
| DHHS IHS Phoenix Area | Family Medicine | Current |
Accepting new patients |
| DHHS PHS Naihs Chinle Comprehensive Health Care Facility | Current |
Accepting new patients | |
| San Carlos Apache Healthcare Corporation | Current |
Accepting new patients |
Locations
103 Medicine Way Rd
Peridot, AZ 85542
Phone (928) 475-1200
2200 E Show Low Lake Rd
Show Low, AZ 85901
Phone (928) 537-4375
401 Picacho Rd
Winterhaven, CA 92283
Phone (760) 572-4100
4100 W 150th St
Cleveland, OH 44135
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 44352 | AZ | Yes |
Addresses
Primary practice location
200 West Hospital Drive
Whiteriver, AZ 85941-0860
Mailing address
520 Rose LN
200 West Hospital Drive
Wickenburg, AZ 85390-1447
Phone (928) 668-1811
Other providers in Whiteriver, AZ
- James K Ireland
- Frederick Wright Jaeger
- Lia M Jasperse
- Algimantas L Jecius
- Tiffany Rose Jenkins
- Jason Johnson
- Katie Erin Johnson
- Marcus Timothy Johnson
- Troy Lee Johnson
- Laura Anne Jordan
All providers in Whiteriver, AZ · Family Medicine Physician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.