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PRIME CARE MEDICAL CENTER LLC
NPI 1821436155
Clinic/Center - Primary Care in Tuskegee, AL

Active since June 09, 2013CLIA 01D2060405 · Waiver
203 W LEE ST, TUSKEGEE, AL 36083(334) 663-3587(334) 821-6287 Get Directions Write a Review

NPPES record last updated: June 9, 2013. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Prime Care Medical Center Llc NPPES

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

PRIME CARE MEDICAL CENTER LLC (NPI 1821436155) is a healthcare organization registered as a primary care in Tuskegee, Alabama and active in the NPI registry since June 2013. The organization holds a CLIA Waiver certificate valid through June 10, 2027 and lists Fazle Matin, Director, as its authorized official.

NPPES Registry Identity

NPI1821436155
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NamePRIME CARE MEDICAL CENTER LLC
Location Address203 W LEE STTuskegee, AL 36083-1719
Mailing Address2220 Mt Vernon LnAuburn, AL 36830-4257 · (334) 821-6287
Phone(334) 663-3587
Fax(334) 821-6287
Organization SubpartNo
Authorized OfficialFazle MatinDirector · (334) 663-3587
Enumeration DateJune 9, 2013
✔ NPI 1821436155 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
203 W LEE ST, Tuskegee, AL 36083
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Prime Care Medical Center Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Prime Care Medical Center LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Deanah Maxwell, MD
Family Practice
NPI 1124214770
1121 BELLEVILLE AVE
Brewton, AL 36426
(251) 809-3220
✔ PECOS✔ Accepts Medicare121 mi

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 01D2060405

Prime Care Medical Center · Tuskegee, AL
Active · expires Jun 10, 2027
CLIA Number01D2060405
Laboratory TypePhysician Office
Certificate Effective DateJune 11, 2025
Certificate Expiration DateJune 10, 2027
Laboratory DirectorDr. Fazle Matin MD
Laboratory Phone(334) 727-7050
Laboratory LocationPrime Care Medical Center203 West Lee Street, Tuskegee, AL 36083
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

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 Prime Care Medical Center LLC's NPI number?

The NPI number for Prime Care Medical Center LLC is 1821436155. It was assigned to this organization in the NPPES registry on June 9, 2013.

Where is Prime Care Medical Center LLC located?

Prime Care Medical Center LLC is located at 203 W Lee St, Tuskegee, AL 36083. The listed phone number is (334) 663-3587.

What is Prime Care Medical Center LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Is Prime Care Medical Center LLC enrolled in Medicare?

Yes. Prime Care Medical Center LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Prime Care Medical Center LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Prime Care Medical Center LLC. 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 Prime Care Medical Center LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 01D2060405) is associated with this NPI, valid through June 10, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Prime Care Medical Center LLC was last updated on June 9, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.