Flagstaff Family Care Clinic – Family Medicine Physician, NPI 1699724039
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Flagstaff Family Care Clinic
PO BOX 35380
LAS VEGAS, NV 891335380
Phone: (702) 954-7761
Type: Mailing
1501 S YALE ST STE 150
FLAGSTAFF, AZ 860017337
Phone: (928) 527-4325
Fax: (928) 527-4327
Type: Location
2001 N 4th St
Flagstaff, AZ 860044227
Phone: (928) 527-4325
Fax: (928) 527-4327
Type: Location
3190 N WINDSONG DR
PRESCOTT VALLEY, AZ 863142239
Phone: (928) 800-5701
Fax: (928) 800-5702
Type: Mailing
Arizona Behavioral Health Associates, P.C. & Psychotherapy.Com, 710, North Beaver Street, Downtown Flagstaff, Flagstaff, Coconino County, Arizona, 86001-3139, United States
BLDG 6
FLAGSTAFF, AZ 86001
Phone: (928) 527-4325
Fax: (928) 527-4327
Type: Location
1501, South Yale Street, Flagstaff, Coconino County, Arizona, 86001, United States
BLDG 2, SUITE 150
FLAGSTAFF, AZ 86001
Phone: (928) 527-4325
Fax: (928) 527-4327
Type: Mailing
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: 2004-05-22
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20040522000252 | O | Clinic/Group Practice | AZ | TBD |
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.
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 89133)
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