BETHEL FAMILY CLINIC
NPI 1124078019
Clinic/Center - Federally Qualified Health Center (FQHC) in Bethel, AK
About Bethel Family Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BETHEL FAMILY CLINIC (NPI 1124078019) is a healthcare organization registered as a federally qualified health center (fqhc) in Bethel, Alaska and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through June 28, 2028 and lists Suzanne Niemi, Finance, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
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)
Bethel Family Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
9Medicare enrollment records show 9 clinicians reassign Medicare billing to Bethel Family Clinic, which bills Medicare for the services they deliver. Of these, 3 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (9)
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 02D0705422
Bethel Family Clinic · Bethel, AKFrequently 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 Bethel Family Clinic's NPI number?
The NPI number for Bethel Family Clinic is 1124078019. It was assigned to this organization in the NPPES registry on May 11, 2006.
Where is Bethel Family Clinic located?
Bethel Family Clinic is located at 631 Main Street, Bethel, AK 99559. The listed phone number is (907) 543-3773.
What is Bethel Family Clinic's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.
Is Bethel Family Clinic enrolled in Medicare?
Yes. Bethel Family Clinic is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Bethel Family Clinic?
According to the CMS Revalidation Reassignment List (October 2026 release), 9 clinicians in 4 Medicare specialties reassign their Medicare billing to Bethel Family Clinic. 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. The largest specialties are Nurse Practitioner (6), Mental Health Counselor (1) and Pediatric Medicine (1). Of these, 3 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Bethel Family Clinic hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 02D0705422) is associated with this NPI, valid through June 28, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Bethel Family Clinic accept?
Health plans from Premera Blue Cross Blue Shield of Alaska list Bethel Family Clinic 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 Bethel Family Clinic was last updated on November 27, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Bethel Family Clinic · NPI 1124078019
Federally Qualified Health Center (FQHC) organization in Bethel, Alaska. Organization record, active in the CMS NPPES registry since May 11, 2006.
## Identity
- **NPI:** 1124078019 (Entity type: Organization)
- **Enumerated:** May 11, 2006
- **Primary specialty:** Clinic/Center - Federally Qualified Health Center (FQHC) · taxonomy 261QF0400X
- **Organization subpart:** No
- **Authorized official:** Suzanne Niemi, FINANCE
## Practice location
- **Address:** 631 MAIN STREET, Bethel, AK 99559-1908
- **Phone:** (907) 543-3773 · **Fax:** (907) 543-3545
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 9 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (6), Mental Health Counselor (1), Pediatric Medicine (1); 3 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 27, 2018
- **Other identifiers:** Medicaid 1029936 (AK); Other 02-1835 (AK)
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1124078019) · Data from the CMS NPPES public registry.