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CONNIE M EBACH NP
NPI 1053417493
Nurse Practitioner in Fort Defiance, AZ

Active since September 15, 2006PECOS EnrolledAccepts Medicare Assignment
CORNER OF ROUTE N12 AND N7, FORT DEFIANCE, AZ 86504(928) 729-8000 Get Directions Write a Review

NPPES record last updated: April 23, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 21, 2022, Mar 17, 2018, Aug 7, 2017 (3 updates tracked since 2017).

About Connie M Ebach Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CONNIE M EBACH NP (NPI 1053417493) is an individual nurse practitioner in Fort Defiance, Arizona, licensed in North Dakota (R22087) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS, is affiliated with Chi St Alexius Health Williston, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1053417493
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameCONNIE M EBACHCredential: NP
Location AddressCORNER OF ROUTE N12 AND N7Fort Defiance, AZ 86504
Mailing AddressPo Box 649Fort Defiance, AZ 86504-0649 · (928) 729-8000
Phone(928) 729-8000
Sole ProprietorNo
Medical School CMSOtherGraduated 2001
Enumeration DateSeptember 15, 2006
Last NPPES UpdateApril 23, 20253 updates tracked since enumeration
NPPES CertifiedApril 15, 2025
✔ NPI 1053417493 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in ND · R22087
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
CORNER OF ROUTE N12 AND N7, Fort Defiance, AZ 86504
Open in Google Maps ↗

Secondary Practice Locations 2

Location 11058 College DrNew Town, ND 58763-9112 · Phone (701) 627-4750 · Fax (701) 627-2809
Location 2222 N 7th StBismarck, ND 58501-4436 · Phone (701) 323-6000 · Fax (701) 323-5709

Other Identifiers 1

Medicaid19686ND

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of North Dakota.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Connie M Ebach Np is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1759379258
PECOS Enrollment IDI20040504000454, I20160820000032
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

4

Medicare enrollment records show Connie Ebach reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

The Fort Defiance Indian Hospital Board, Incorporation
0.4 mi
General Acute Care Hospital
CORNER OF ROUTE N12 & N7
Fort Defiance, AZ 86504
  • Reassigned Medicare billing, Texas enrollment
  • 518 clinicians in this Medicare group
NPI 1477876639 (928) 729-8000
Mckenzie County Healthcare Systems Inc
884 mi
Critical Access
709 4TH AVE NE
Watford City, ND 58854
  • Reassigned Medicare billing, North Dakota enrollment
  • 108 clinicians in this Medicare group
NPI 1518988948 (701) 843-3771
Trenton Indian Service Area
892 mi
Clinic/Center
331 4TH AVE E
Trenton, ND 58853
  • Reassigned Medicare billing, Texas enrollment
  • 11 clinicians in this Medicare group
NPI 1568574036 (701) 774-0461
Elbowoods Memorial Health Center
909 mi
Clinic/Center
1251 ELBOWOODS LOOP
New Town, ND 58763
  • Reassigned Medicare billing, North Dakota enrollment
  • 51 clinicians in this Medicare group
NPI 1831365519 (701) 627-4750

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
35 services28 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
23 services19 patients
Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
16 services15 patients
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025
A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.
16 services16 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
13 services13 patients
Blood test, lipids (cholesterol and triglycerides) 80061
A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.
11 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Chi St Alexius Health Williston

Critical Access Hospitals · Williston, ND
OwnershipVoluntary non-profit - Church
CMS Certification Number351334
Location1301 15th Ave WWilliston, ND 58801 · Williams County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 86504 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.89 typical visit price
range $55.44 – $168.60
Typical copayment $21.47 (range $13.86 – $42.15)
Most-billed visit code 99203
Established Patient
$98.00 typical visit price
range $17.72 – $137.41
Typical copayment $24.50 (range $4.43 – $34.35)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ROMULO LAURETA PARUNGAO M.D.
Emergency Medicine
CORNER OF ROUTE N12 AND N7
FORT DEFIANCE, AZ 86504
Apache County (928) 729-8600
CHARLES EATON PAGE
Emergency Medicine
CORNER OF ROUTE N12 AND N7
FORT DEFIANCE, AZ 86504
Apache County (928) 729-8000
JAY S GUIKEMA FNP
Nurse Practitioner (Family)
CORNER OF ROUTE N12 AND N7
FORT DEFIANCE, AZ 86504
Apache County (928) 729-8000
MARIBEL PASTRAN RD, CD
Dietitian, Registered
CORNER OF ROUTE N12 AND N7
FORT DEFIANCE, AZ 86504
Apache County (928) 729-8000
PONY NANCY SOKIRI PA-C
Physician Assistant
CORNER OF ROUTE N12 AND N7, CORNER OF ROUTE N12 AND N7
FORT DEFIANCE, AZ 86504
Apache County (928) 729-8000
SARAH R WILLIAMS PT
Physical Therapist
CORNER OF ROUTE N12 AND N7
FORT DEFIANCE, AZ 86504
Apache County (928) 729-8000
JOHN NORBERT
Family Medicine
CORNER OF ROUTE N12 AND N7
FORT DEFIANCE, AZ 86504
Apache County (928) 729-8000
DR. LINDA BROWN TRUDEL MD
Family Medicine
CORNER OF ROUTE N12 AND N7
FORT DEFIANCE, AZ 86504
Apache County (928) 729-8000

Frequently 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 Connie Ebach's NPI number?

The NPI number for Connie Ebach is 1053417493. It was assigned to this individual provider in the NPPES registry on September 15, 2006.

Where is Connie Ebach located?

Connie Ebach practices at Corner Of Route N12 And N7, Fort Defiance, AZ 86504. The listed phone number is (928) 729-8000.

What is Connie Ebach's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Connie Ebach enrolled in Medicare?

Yes. Connie Ebach is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Connie Ebach's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Connie Ebach reassigns Medicare benefits to 4 organizations: The Fort Defiance Indian Hospital Board, Incorporation (Fort Defiance, AZ), Mckenzie County Healthcare Systems Inc (Watford City, ND), Trenton Indian Service Area (Trenton, ND) and Elbowoods Memorial Health Center (New Town, ND). Each 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 Connie Ebach's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Connie Ebach accept?

Health plans from Blue Cross Blue Shield of North Dakota list Connie Ebach as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Connie Ebach affiliated with any hospitals?

According to CMS data, Connie Ebach is affiliated with Chi St Alexius Health Williston.

When was this NPI record last updated?

The NPPES record for Connie Ebach was last updated on April 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months 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.