Individual provider Active NPI

Charles A Cluff, D.O.

  • Anesthesiology Physician
  • Cottonwood, AZ
National Provider Identifier
1235494709
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
006934 Issued in AZ
Practice address
269 S Candy LN
Cottonwood, AZ 86326-4158
Phone
(928) 639-6150
Fax
(928) 639-6561
NPI assigned
Jul 10, 2012
Last updated
Mar 14, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 006934 AZ Primary

Addresses

Primary practice location

269 S Candy LN
Cottonwood, AZ 86326-4158

Mailing address

1200 N Beaver St
Payer Credentialing
Flagstaff, AZ 86001-3118
Phone (928) 213-6235

Other identifiers 1

IdentifierTypeStateIssuer
157768MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, AZ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150827000850 MO Practitioner - Anesthesiology 6103132709 Reassigns benefits to 1 organization
I20160609000835 AZ Practitioner - Anesthesiology 6103132709 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1215 N Beaver St
Suite 203
Flagstaff, AZ 86001-3126
Phone (928) 773-2249

2000 S Thompson St
Flagstaff, AZ 86001-8759
Phone (928) 226-6400

269 S Candy LN
Cottonwood, AZ 86326-4158
Phone (928) 639-6000

340 S Willard St
Cottonwood, AZ 86326-4126
Phone (928) 639-6025

7810 N US Hwy 89
Flagstaff, AZ 86004-6255
Phone (928) 522-8375

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Scotland County Memorial Hospital Current Accepting new patients
Northern Arizona Healthcare Corporation CurrentSince Oct 16, 2018 Accepting new patients
Flagstaff Pathology Associates Current Accepting new patients
Scotland County Memorial Hospital CurrentSince Jul 25, 2015 Accepting new patients
Scotland County Memorial Hospital CurrentSince Jul 25, 2015 Accepting new patients
Northern Arizona Healthcare Corporation Anesthesiology Current Accepting new patients

Locations

269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251

1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235

1215 N Beaver St
Ste 203
Flagstaff, AZ 86001
Phone (928) 773-2249

450 E Sigler Ave
Memphis, MO 63555
Phone (660) 465-2828

450 E Sigler Ave
Ste A
Memphis, MO 63555
Phone (660) 465-2828

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1341878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489449600000",
    "number": "1235494709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N BEAVER ST",
            "address_2": "PAYER CREDENTIALING",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013118",
            "telephone_number": "928-213-6235",
            "fax_number": "928-213-6292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 S CANDY LN",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863264158",
            "telephone_number": "928-639-6150",
            "fax_number": "928-639-6561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLUFF",
        "first_name": "CHARLES",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-10",
        "last_updated": "2017-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "006934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "157768",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottonwood, AZ

Sources for this page

Verify at the official NPI Registry.