Francisco J Chacon Jr., M.D
Individual provider Active NPI Family Medicine Physician · Liberal, KS
NPI 1376701144 · NPPES record last updated Oct 27, 2021
Key facts
- NPI
- 1376701144
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 04-33980 (KS)
- Practice address
- 315 W 15TH St
Liberal, KS 67901-2455 - Phone
- (620) 624-1651
- NPI assigned
- May 29, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Hospitalist
- Education
- University of Kansas School of Med (KC/Wich/Sal), 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Memorial Hospital of Texas County Authority
Practice addresses (Care Compare)
421 Medical Dr
Guymon, OK 73942-3640
Phone (580) 338-6515
520 Medical Dr
Guymon, OK 73942-4438
Phone (580) 338-6515
Hospital & facility affiliations
- Memorial Hospital of Texas County Authority
- Memorial Hospital of Texas County Authority
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- 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 |
|---|---|---|---|---|
| I20211123002159 | OK | Practitioner - Hospitalist |
6406996131 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04-33980 | KS | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Hospital of Texas County Authority | Current |
Accepting new patients | |
| Memorial Hospital of Texas County Authority | Current |
Accepting new patients | |
| Mercy Kansas Communities Inc | Past | Accepting new patients |
Locations
421 Medical Dr
Guymon, OK 73942
Phone (580) 338-3135
520 Medical Dr
Guymon, OK 73942
Phone (580) 338-3113
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 6964 | KS | |
| Family Medicine Physician | 207Q00000X | 04-33980 | KS | Yes |
Addresses
Primary practice location
315 W 15TH St
Liberal, KS 67901-2455
Mailing address
PO Box 2020
Olathe, KS 66051-2020
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200624220V | Medicaid | KS | |
| 200080679 | Medicaid | MO |
Other providers in Liberal, KS
- Carmelita Caedo MD Radiology PA
- Theresa Carrillo
- Linsey Kay Carter
- Central Care, PA
- Central Care, PA
- Rama Krishna Reddy Chanda
- Child Psychiatry LLC
- Cimarron Pathology PA
- City on a Hill Inc
- Michelle Lyn Cochran
All providers in Liberal, KS · Family Medicine Physician in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 27, 2021. 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.