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MED PAVILION PC
NPI 1871643007
Internal Medicine in Mineral Wells, TX

Active since January 11, 2007
220A SW 26TH AVE, MINERAL WELLS, TX 76067(940) 325-1543(940) 325-2679 Get Directions Write a Review

NPPES record last updated: February 13, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Med Pavilion Pc NPPES

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

MED PAVILION PC (NPI 1871643007) is a healthcare organization registered as an internal medicine in Mineral Wells, Texas and active in the NPI registry since January 2007. The organization lists Ashley R Wright, Clinic Coordinator, as its authorized official.

NPPES Registry Identity

NPI1871643007
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameMED PAVILION PC
Location Address220A SW 26TH AVEMineral Wells, TX 76067
Mailing Address220a Sw 26th AveMineral Wells, TX 76067-8248 · (940) 325-1543 · Fax (940) 325-2679
Phone(940) 325-1543
Fax(940) 325-2679
Organization SubpartNo
Authorized OfficialAshley R WrightClinic Coordinator · (940) 325-1543
Enumeration DateJanuary 11, 2007
Last NPPES UpdateFebruary 13, 2026
NPPES CertifiedFebruary 13, 2026
✔ NPI 1871643007 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in TX · J4552
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedPediatricsTaxonomy 208000000X · License J4552 (TX)
220A SW 26TH AVE, Mineral Wells, TX 76067
Open in Google Maps ↗

Other Identifiers 4

Other80780YBcbs
Medicaid135150408TX
Medicaid135150406TX
OtherTXB158020TX · Ptan

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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)

Med Pavilion Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by January 31, 2027

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.

StateEnrollment IDDue date
StateTexasEnrollment IDO20120810000020Non-DME Part B · Clinic/Group PracticeDue dateJanuary 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Med Pavilion PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Tom Tarkenton, D.O.
Internal Medicine
NPI 1306824651
220 SW 26TH AVE STE A
Mineral Wells, TX 76067
(940) 325-1543
✔ PECOS✔ Accepts MedicareSame address

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 Med Pavilion PC's NPI number?

The NPI number for Med Pavilion PC is 1871643007. It was assigned to this organization in the NPPES registry on January 11, 2007.

Where is Med Pavilion PC located?

Med Pavilion PC is located at 220A SW 26th Ave, Mineral Wells, TX 76067. The listed phone number is (940) 325-1543.

What is Med Pavilion PC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Med Pavilion PC enrolled in Medicare?

Yes. Med Pavilion PC is registered in the Medicare PECOS enrollment system.

When is Med Pavilion PC'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 January 31, 2027. 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 Med Pavilion PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Med Pavilion PC. 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.

When was this NPI record last updated?

The NPPES record for Med Pavilion PC was last updated on February 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.