Northern Apache County Special Health Care District

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

OTC2967 Issued in AZ

Legal business name

NORTHERN APACHE COUNTY SPECIAL HEALTH CARE DISTRICT

Doing business as

St. Michaels Clinic

Practice address

359-A West Highway 264
St Michaels, AZ 86511-0370

Phone

(928) 810-3800

Fax

(928) 810-3811

NPI assigned

Sep 21, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Denikka Sue Tsosie

Title

Revenue Cycle Specialist

Phone

(928) 810-3800

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• St. Michaels Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Northern Apache County Special Health Care District

  • Primary Care Clinic/Center
  • Sanders, AZ
  • NPI 1235238700

  O20100202000078

  Same enrollment

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Susan L Elizondo, M.D.

  • Family Medicine Physician
  • St Michaels, AZ
  • NPI 1033166038
  NPD (past)

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651104000000",
    "number": "1326147893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "ST MICHAELS",
            "state": "AZ",
            "postal_code": "865110370",
            "telephone_number": "928-810-3800",
            "fax_number": "928-810-3811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "359-A WEST HIGHWAY 264",
            "city": "ST MICHAELS",
            "state": "AZ",
            "postal_code": "865110370",
            "telephone_number": "928-810-3800",
            "fax_number": "928-810-3811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN APACHE COUNTY SPECIAL HEALTH CARE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A",
        "authorized_official_last_name": "TSOSIE",
        "authorized_official_first_name": "DENIKKA",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "REVENUE CYCLE SPECIALIST",
        "authorized_official_telephone_number": "928-810-3800",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AZ",
            "license": "OTC2967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "709248",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Michaels Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. Michaels Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rez Liwag Cortez
• Susan L Elizondo, M.D.
• Patricia F Hogan, LCSW, LMT
• Erica Lynn Kish, PT, MPT
• Northern Apache County Special Health Care District
• Northern Apache County Special Health Care District
• Professional Behavioral Health Services of St. Michaels
• Sacred Mountain Home Care
• Sacred Sun Transport
• Sequel Tsi of Az, LLC

• Primary Care Clinic/Center in St Michaels, AZ
• Providers in St Michaels, AZ by specialty
• Primary Care Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.