PECOS COUNTY MEMORIAL HOSPITAL
NPI 1457307175
Family Medicine in Fort Stockton, TX
About Pecos County Memorial Hospital NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PECOS COUNTY MEMORIAL HOSPITAL (NPI 1457307175) is a healthcare organization registered as a family medicine in Fort Stockton, Texas and active in the NPI registry since May 2006. The organization holds a CLIA Microscopy certificate valid through March 26, 2028 and lists Melissa Pena, Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 3
Group Practice 1
Accepted Insurance
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)
Pecos County Memorial Hospital 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
22Medicare enrollment records show 22 clinicians reassign Medicare billing to Pecos County Memorial Hospital, which bills Medicare for the services they deliver. Of these, 6 practice at this address and 10 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 4
Nearest to this location (20)
See all 22Source: 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 for Provider-Performed Microscopy Procedures (PPMP) 45D0508889
Pecos County Memorial Hospital D/B/A Family Care Walk-In Clinic · Fort Stockton, TXFrequently 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 Pecos County Memorial Hospital's NPI number?
The NPI number for Pecos County Memorial Hospital is 1457307175. It was assigned to this organization in the NPPES registry on May 25, 2006.
Where is Pecos County Memorial Hospital located?
Pecos County Memorial Hospital is located at 387 West Ih 10, Fort Stockton, TX 79735. The listed phone number is (432) 336-2058.
What is Pecos County Memorial Hospital's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Pecos County Memorial Hospital enrolled in Medicare?
Yes. Pecos County Memorial Hospital is registered in the Medicare PECOS enrollment system.
When is Pecos County Memorial Hospital'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 (Texas, 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 Pecos County Memorial Hospital?
According to the CMS Revalidation Reassignment List (October 2026 release), 22 clinicians in 4 Medicare specialties reassign their Medicare billing to Pecos County Memorial Hospital. 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 Certified Registered Nurse Anesthetist (CRNA) (8), Family Practice (8) and Nurse Practitioner (5). Of these, 6 practice at this address and 10 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Pecos County Memorial Hospital hold a CLIA laboratory certificate?
Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 45D0508889) is associated with this NPI, valid through March 26, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Pecos County Memorial Hospital accept?
Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 2 other insurers list Pecos County Memorial Hospital 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 Pecos County Memorial Hospital was last updated on November 8, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Pecos County Memorial Hospital · NPI 1457307175
Family Medicine organization in Fort Stockton, Texas. Organization record, active in the CMS NPPES registry since May 25, 2006.
## Identity
- **NPI:** 1457307175 (Entity type: Organization)
- **Enumerated:** May 25, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Melissa Pena, DIRECTOR
## Practice location
- **Address:** 387 WEST IH 10, Fort Stockton, TX 79735-2700
- **Phone:** (432) 336-2058 · **Fax:** (844) 824-3604
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, Texas, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 22 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Certified Registered Nurse Anesthetist (CRNA) (8), Family Practice (8), Nurse Practitioner (5); 6 practice at this address and 10 within 10 miles; [full list](https://npiprofile.com/npi/1457307175/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 8, 2019
- **Other identifiers:** Medicaid 091939102 (TX); Other 0079AE (TX); Medicaid 091939103 (TX)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1457307175) · Data from the CMS NPPES public registry.