Nov 30, 2025Established date
Non-DME Part BClinic/Group Practice · O20190125001690
Providence Health & Services MtOR · NPI 1215222617
Nov 30, 2025Established date
Non-DME Part BClinic/Group Practice · O20190128001139
Providence Health & Services MtWA · NPI 1215222617
Dec 31, 2025Established date
Non-DME Part BClinic/Group Practice · O20190129003961
Providence Health & Services MtAK · NPI 1215222617
Jan 31, 2026Established date
Non-DME Part BClinic/Group Practice · O20190508002635
Providence Health & Services MtCA · NPI 1215222617
Jun 30, 2026Established date
Non-DME Part BClinic/Group Practice · O20200824000195
Providence Health & Services MtFL · NPI 1215222617
Aug 31, 2026Established date
Non-DME Part BClinic/Group Practice · O20200831001817
Providence Health & Services MtMO · NPI 1215222617
Sep 30, 2026Established date
Non-DME Part BClinic/Group Practice · O20200917000431
Providence Health & Services MtMI · NPI 1215222617
Oct 31, 2026Established date
Non-DME Part BClinic/Group Practice · O20200923001208
Providence Health & Services MtDC · NPI 1215222617
TBDNo date established
Non-DME Part BClinic/Group Practice · O20031229000787
Providence Health & Services MtMT · NPI 1215222617
TBDNo date established
Non-DME Part BClinic/Group Practice · O20101227000036
Providence Health & Services MtID · NPI 1215222617
TBDNo date established
Non-DME Part BClinic/Group Practice · O20190116003053
Providence Health & Services MtCO · NPI 1215222617
TBDNo date established
Non-DME Part BClinic/Group Practice · O20201002001305
Providence Health & Services MtHI · NPI 1215222617
TBDNo date established
Non-DME Part BClinic/Group Practice · O20201008002086
Providence Health & Services MtNV · NPI 1215222617
TBDNo date established
Non-DME Part BClinic/Group Practice · O20210107000846
Providence Health & Services MtNY · NPI 1215222617
TBDNo date established
Non-DME Part BClinic/Group Practice · O20210713001811
Providence Health & Services MtTX · NPI 1215222617
TBDNo date established
Non-DME Part BClinic/Group Practice · O20230206000159
Providence Health & Services MtMN · NPI 1215222617
TBDNo date established
Non-DME Part BClinic/Group Practice · O20230310000411
Providence Health & Services MtAZ · NPI 1215222617
TBDNo date established
Non-DME Part BClinic/Group Practice · O20240118004347
Providence Health & Services MtIL · NPI 1215222617
TBDNo date established
Non-DME Part BClinic/Group Practice · O20240906001372
Providence Health & Services MtNE · NPI 1215222617
TBDNo date established
Non-DME Part BClinic/Group Practice · O20240910002148
Providence Health & Services MtWI · NPI 1215222617
TBDNo date established
Non-DME Part BClinic/Group Practice · O20250305000754
Providence Health & Services MtUT · NPI 1215222617
TBDNo date established
Non-DME Part BClinic/Group Practice · O20250721002882
Providence Health & Services MtNC · NPI 1215222617
TBDNo date established
Non-DME Part BClinic/Group Practice · O20251013004133
Providence Health & Services MtNJ · NPI 1215222617
TBDNo date established
Non-DME Part BClinic/Group Practice · O20251016002731
Providence Health & Services MtTN · NPI 1215222617
A blank due date means CMS has not established a revalidation due date for that enrollment in the current public list. A public due date is not confirmation that a revalidation was submitted, received, accepted, or completed. Use PECOS and the responsible enrollment contractor for official submission and case status. Source revision df56c39b5841c848fecb343f7a9738e7afb4d098.