PEDIATRIC ASSOCIATES PROF LLC – Rural Health Clinic/Center, NPI 1043016124

PEDIATRIC ASSOCIATES PROF LLC is a healthcare provider. based in Montrose, Colorado. specializing in Rural Health Clinic/Center. The NPI Number for PEDIATRIC ASSOCIATES PROF LLC is 1043016124

Main info

Organization
Name
PEDIATRIC ASSOCIATES PROF LLC
NPI
1043016124
Phone
(970) 249-2421
Address
947 SOUTH 5TH STREET
Authorized Official
AMBER HICKERT PRACTICE ADMINISTRATOR
Enumeration Date
20 February 2025
Last Update Date
20 February 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience17
Completeness75
Years active:1State licenses:0Digital endpointsOther names

Provider Addresses for PEDIATRIC ASSOCIATES PROF LLC

  • 947 SOUTH 5TH STREET

    MONTROSE, CO 81401

    Phone: (970) 249-2421

    Fax: (855) 638-4966

    Type: Mailing

  • 242 COTTONWOOD ST

    DELTA, CO 814164403

    Phone: (970) 874-7552

    Fax: (855) 638-4966

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-02-23

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20240223002210ORural Health ClinicCOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 81401)

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Reviews

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Frequently asked questions

What identifier follows PEDIATRIC ASSOCIATES PROF LLC across health systems?
The NPI 1043016124 uniquely identifies PEDIATRIC ASSOCIATES PROF LLC in U.S. healthcare data.
Does the public listing show PEDIATRIC ASSOCIATES PROF LLC as active?
PEDIATRIC ASSOCIATES PROF LLC's NPI record reflects an active status in NPPES.
What does the directory say PEDIATRIC ASSOCIATES PROF LLC does?
Insurance directories may phrase it differently, but here PEDIATRIC ASSOCIATES PROF LLC maps to Rural Health Clinic/Center. Clinical services aligned with this taxonomy classification.
Which community is linked to PEDIATRIC ASSOCIATES PROF LLC?
PEDIATRIC ASSOCIATES PROF LLC shows a connection to Montrose, Colorado in registry-derived data.
Why is information missing for PEDIATRIC ASSOCIATES PROF LLC?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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PEDIATRIC ASSOCIATES PROF LLC

Rural Health Clinic/Center
947 S 5TH ST
NPI: 1780480855