Bristol Bay Area Health Corporation
Organization Active NPI Clinic/Center · New Stuyahok, AK
NPI 1720148976 · NPPES record last updated Oct 6, 2023
Key facts
- NPI
- 1720148976
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- BRISTOL BAY AREA HEALTH CORPORATION
- Practice address
- 109 Main Street
New Stuyahok, AK 99636 - Phone
- (907) 842-5201
- Fax
- (907) 842-9250
- NPI assigned
- Dec 11, 2006
- Organization subpart
- No
Authorized official
- Name
- Cathy Leeann Taylor
- Title
- Provider Enrollment Specialist
- Phone
- (907) 842-5201
Other NPIs on the same Medicare enrollment 38
Practitioners 321
-
Avram Eli Adelman, M.D.
-
Lisa M Alexia, PA-C
-
Christi M. Angelo, APRN-F/AC
-
Richard W Asher, MD
-
Kira Bendixen, DO
-
Robert Brenteson, MD
-
Eli Dylan Bress, DO
-
Dirk C Bringhurst, M.D.
-
Clay Brown, PT
-
Laina Gay Cafego, D.O.
-
Tirza Cannon, MD, MPH
-
Olegario Carrillo, PA-C
-
Melissa Norma Cockrell, APRN, NP-C
-
Mario Cruz, OD
-
Paul W Davis, MD
-
Myra Dimitrov Dimitrov, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031120000998 | TX | Part B Supplier - Clinic/Group Practice | 5890699920 |
Receives reassigned benefits from 432 practitioners 44 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Lebelock, AK; Manokotak, AK; Goodnews Bay, AK; Naknek, AK; New Stuyahok, AK; Perryville, AK; Pilot Point, AK; Platinum, AK… |
| O20190304000785 | TX | Part B Supplier - Mass Immunization (Roster Biller Only) | 5890699920 |
21 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Goodnews Bay, AK; Twin Hills, AK; Togiak, AK; South Naknek, AK; Port Heiden, AK; Platinum, AK; Pilot Point, AK; Perryville, AK… |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Yes |
Addresses
Primary practice location
109 Main Street
New Stuyahok, AK 99636
Mailing address
PO Box 130
Dillingham, AK 99576-0130
Phone (907) 842-5201
Other names
- NEW STUYAHOK CLINIC
Other providers in New Stuyahok, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 6, 2023. 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.