TONOPAH PRIMARY CARE LLC
NPI 1003305616
Nurse Practitioner - Family in Tonopah, NV
About Tonopah Primary Care Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TONOPAH PRIMARY CARE LLC (NPI 1003305616) is a healthcare organization registered as a family in Tonopah, Nevada and active in the NPI registry since May 2018. The organization holds a CLIA Waiver certificate valid through March 17, 2027 and lists Eljena Marie Peterson, Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Tonopah Primary Care Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Tonopah Primary Care LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 29D0926246
Tonopah Primary Care LLC · Tonopah, NVFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Tonopah Primary Care LLC's NPI number?
The NPI number for Tonopah Primary Care LLC is 1003305616. It was assigned to this organization in the NPPES registry on May 9, 2018.
Where is Tonopah Primary Care LLC located?
Tonopah Primary Care LLC is located at 119 St. Patrick, Tonopah, NV 89049. The listed phone number is (775) 482-9898.
What is Tonopah Primary Care LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Tonopah Primary Care LLC enrolled in Medicare?
Yes. Tonopah Primary Care LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Tonopah Primary Care LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Tonopah Primary Care LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Tonopah Primary Care LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 29D0926246) is associated with this NPI, valid through March 17, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Tonopah Primary Care LLC was last updated on May 9, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Tonopah Primary Care Llc · NPI 1003305616
Family organization in Tonopah, Nevada. Organization record, active in the CMS NPPES registry since May 9, 2018.
## Identity
- **NPI:** 1003305616 (Entity type: Organization)
- **Enumerated:** May 9, 2018
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Eljena Peterson, MANAGER
## Practice location
- **Address:** 119 ST. PATRICK, Tonopah, NV 89049
- **Phone:** (775) 482-9898 · **Fax:** (775) 482-9900
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 9, 2018
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1003305616) · Data from the CMS NPPES public registry.