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NORTHWEST ARKANSAS INTERNAL MEDICINE, PLLC
NPI 1053615211
Internal Medicine in Bentonville, AR

Active since January 03, 2011
2805 MID CITIES DR, SUITE 3, BENTONVILLE, AR 72712(479) 876-8866 Get Directions Write a Review

NPPES record last updated: January 3, 2011. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Northwest Arkansas Internal Medicine, Pllc NPPES

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

NORTHWEST ARKANSAS INTERNAL MEDICINE, PLLC (NPI 1053615211) is a healthcare organization registered as an internal medicine in Bentonville, Arkansas and active in the NPI registry since January 2011. The organization lists Ruben Tejada, Owner, as its authorized official.

NPPES Registry Identity

NPI1053615211
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameNORTHWEST ARKANSAS INTERNAL MEDICINE, PLLC
Location Address2805 MID CITIES DR, SUITE 3Bentonville, AR 72712-4270
Mailing Address2805 Mid Cities Dr, Suite 3Bentonville, AR 72712-4270 · (479) 876-8866
Phone(479) 876-8866
Organization SubpartNo
Authorized OfficialRuben TejadaOwner · (479) 751-8881
Enumeration DateJanuary 3, 2011
✔ NPI 1053615211 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
2805 MID CITIES DR, Bentonville, AR 72712
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Northwest Arkansas Internal Medicine, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by November 30, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateArkansasEnrollment IDO20110511000711Non-DME Part B · Clinic/Group PracticeDue dateNovember 30, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Northwest Arkansas Internal Medicine, PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Ruben Tejada, M.D.
Internal Medicine
NPI 1053473231
5212 VILLAGE PKWY SUITE 9
Rogers, AR 72758
(479) 876-8460
✔ PECOS✔ Accepts Medicare1.8 mi

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

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 Northwest Arkansas Internal Medicine, PLLC's NPI number?

The NPI number for Northwest Arkansas Internal Medicine, PLLC is 1053615211. It was assigned to this organization in the NPPES registry on January 3, 2011.

Where is Northwest Arkansas Internal Medicine, PLLC located?

Northwest Arkansas Internal Medicine, PLLC is located at 2805 Mid Cities Dr Suite 3, Bentonville, AR 72712. The listed phone number is (479) 876-8866.

What is Northwest Arkansas Internal Medicine, PLLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Northwest Arkansas Internal Medicine, PLLC enrolled in Medicare?

Yes. Northwest Arkansas Internal Medicine, PLLC is registered in the Medicare PECOS enrollment system.

When is Northwest Arkansas Internal Medicine, PLLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Arkansas, Clinic/Group Practice) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Northwest Arkansas Internal Medicine, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Northwest Arkansas Internal Medicine, PLLC. 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.

When was this NPI record last updated?

The NPPES record for Northwest Arkansas Internal Medicine, PLLC was last updated on January 3, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.