Commonwealth Healthcare Corporation
Organization Active NPI Rural Health Clinic/Center · Tinian, MP
NPI 1003382854 · NPPES record last updated Oct 19, 2018
Key facts
- NPI
- 1003382854
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- COMMONWEALTH HEALTHCARE CORPORATION
- Practice address
- San Jose Village
Corner of Canal Street & Broadway
Tinian, MP 96952 - Phone
- (670) 433-9233
- NPI assigned
- Oct 19, 2018
- Organization subpart
- Yes
- Parent organization (as reported)
- COMMONWEALTH HEALTHCARE CORPORATION
Authorized official
- Name
- Esther L Muna
- Title
- Chief Executive Officer
- Phone
- (670) 234-8950
Other NPIs on the same Medicare enrollment 2
Practitioners 60
-
Nick Jansen, PA-C
-
Brent Wicker Katz, PA-C
-
Dohyun Kim, PA-C
-
Jiayi Kong, MD
-
Renea Dasmarinas Raho, FNP-BC
-
Annie Camacho Trusso, DNAP, CRNA
-
Qiwei Wang, CNP
-
Mark Anders, MD
-
Sarah Ashley, MD
-
Shadi Fawzi Azar, MBBS
-
Sarah Eva Bergman Lewis, M.D.
-
Lingie Chiu, M.D.
-
Mark Denis Daigle, M.D.
-
Gregory Alan Dicamillo, M.D.
-
Tillman Farley, MD
-
Ratchnee France, M.D.
-
Jeffrey James Genato, M.D.
-
Amanda Good, MPH, RN, CPNP
-
Wen-Yu Vicky Haines, M.D.
-
Mohammad Masud Hassan, M.D.
-
Ry Hayler, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MP
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071212000093 | MP | Part B Supplier - Clinic/Group Practice | 7719075167 |
Receives reassigned benefits from 236 practitioners 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Saipan, MP; Tinian, MP; Rota, MP |
National Provider Directory
- Part of
- Commonwealth Healthcare Corporation Outpatient Pharmacy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
San Jose Village
Corner of Canal Street & Broadway
Tinian, MP 96952
Mailing address
PO Box 446
Tinian, MP 96952-0446
Other names
- Tinian Health Center
Other providers in Tinian, MP
- Brabu Pharmacy and Wellness Center LLC
- Kagman Community Health Center Inc
- Aurelia G Mendiola Long
- Pacific Wellness Network Inc
- Tinian Health Center Pharmacy
All providers in Tinian, MP · Rural Health Clinic/Center in Northern Mariana Islands
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 19, 2018. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.