SHOALWATER BAY TRIBAL CLINIC
NPI 1063624740
Clinic/Center - Primary Care in Tokeland, WA
About Shoalwater Bay Tribal Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHOALWATER BAY TRIBAL CLINIC (NPI 1063624740) is a healthcare organization registered as a primary care in Tokeland, Washington and active in the NPI registry since May 2007. The organization lists Michael Rogers, Tribal Administrator, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Shoalwater Bay Tribal Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
5Medicare enrollment records show 5 clinicians reassign Medicare billing to Shoalwater Bay Tribal Clinic, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (5)
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 Shoalwater Bay Tribe's NPI number?
The NPI number for Shoalwater Bay Tribe is 1063624740. It was assigned to this organization in the NPPES registry on May 4, 2007. The provider is doing business as Shoalwater Bay Tribal Clinic.
Where is Shoalwater Bay Tribe located?
Shoalwater Bay Tribe is located at 2373 Old Tokeland Rd, Tokeland, WA 98590. The listed phone number is (360) 267-0119.
What is Shoalwater Bay Tribe's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Shoalwater Bay Tribe enrolled in Medicare?
Yes. Shoalwater Bay Tribe is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Shoalwater Bay Tribe?
According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians reassign their Medicare billing to Shoalwater Bay Tribe, in Family Practice, General Practice, Mental Health Counselor and Nurse Practitioner. 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. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Shoalwater Bay Tribe accept?
Health plans from Ambetter Health and Premera Blue Cross Blue Shield of Alaska list Shoalwater Bay Tribe 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.
When was this NPI record last updated?
The NPPES record for Shoalwater Bay Tribe was last updated on August 25, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.
# Shoalwater Bay Tribal Clinic · NPI 1063624740
Primary Care organization in Tokeland, Washington. Organization record, active in the CMS NPPES registry since May 4, 2007.
## Identity
- **NPI:** 1063624740 (Entity type: Organization)
- **Enumerated:** May 4, 2007
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Legal business name:** Shoalwater Bay Tribe
- **Organization subpart:** No
- **Authorized official:** Michael Rogers, TRIBAL ADMINISTRATOR
## Practice location
- **Address:** 2373 OLD TOKELAND RD, Tokeland, WA 98590
- **Phone:** (360) 267-0119 · **Fax:** (360) 267-0417
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 5 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (2), Family Practice (1), General Practice (1); 1 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 25, 2015
- **Other identifiers:** Medicare OSCAR/certification 501890 (WA)
---
Source: [NPI Profile](https://npiprofile.com/npi/1063624740) · Data from the CMS NPPES public registry.