PLLC
NPI 1063510279
Pediatrics in Bullhead City, AZ
About Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PLLC (NPI 1063510279) is a healthcare organization registered as a pediatrics in Bullhead City, Arizona and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through July 23, 2028 and lists Naila Ashraf Tariq, Physician, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 3
Group Practice 1
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)
Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 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.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to PLLC, 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 03D1001959
Childrens Medical Center · Bullhead City, AZFrequently 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 Childrens Medical Center Of Bullhead City, PLLC's NPI number?
The NPI number for Childrens Medical Center Of Bullhead City, PLLC is 1063510279. It was assigned to this organization in the NPPES registry on September 20, 2006. The provider is also known as PLLC.
Where is Childrens Medical Center Of Bullhead City, PLLC located?
Childrens Medical Center Of Bullhead City, PLLC is located at 1225 Hancock Rd Suite # B, Bullhead City, AZ 86442. The listed phone number is (928) 758-0183.
What is Childrens Medical Center Of Bullhead City, PLLC's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Childrens Medical Center Of Bullhead City, PLLC enrolled in Medicare?
Yes. Childrens Medical Center Of Bullhead City, PLLC is registered in the Medicare PECOS enrollment system.
When is Childrens Medical Center Of Bullhead City, 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 (Arizona, Clinic/Group Practice) is due for revalidation by December 31, 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 Childrens Medical Center Of Bullhead City, PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Pediatric Medicine) reassigns their Medicare billing to Childrens Medical Center Of Bullhead City, 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.
Does Childrens Medical Center Of Bullhead City, PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 03D1001959) is associated with this NPI, valid through July 23, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Childrens Medical Center Of Bullhead City, PLLC was last updated on November 4, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.
# Pllc · NPI 1063510279
Pediatrics organization in Bullhead City, Arizona. Organization record, active in the CMS NPPES registry since September 20, 2006.
## Identity
- **NPI:** 1063510279 (Entity type: Organization)
- **Enumerated:** September 20, 2006
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **Legal business name:** Childrens Medical Center Of Bullhead City, Pllc
- **Organization subpart:** No
- **Authorized official:** Naila Tariq, PHYSICIAN
## Practice location
- **Address:** 1225 HANCOCK RD, SUITE # B, Bullhead City, AZ 86442-5948
- **Phone:** (928) 758-0183 · **Fax:** (928) 758-6665
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, Arizona, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Pediatric Medicine) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 4, 2013
- **Other identifiers:** Medicare UPIN H98492; Medicaid 788531 (AZ); Medicare ID-Type Unspecified Z 77102 (CA)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1063510279) · Data from the CMS NPPES public registry.