Mattawa Community Medical Clinic – Federally Qualified Health Center (FQHC), NPI 1013743210

Mattawa Community Medical Clinic is a healthcare provider. based in Mattawa, Washington. specializing in Federally Qualified Health Center (FQHC). The NPI Number for Mattawa Community Medical Clinic is 1013743210

Main info

Organization
Name
Mattawa Community Medical Clinic
NPI
1013743210
Phone
(509) 932-4499
Address
210 GOVERNMENT RD
Authorized Official
DANA S FOX CEO
Enumeration Date
12 September 2024
Last Update Date
4 December 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience17
Completeness80
Years active:1State licenses:0Digital endpointsUpdated within 12 months

Provider Addresses for Mattawa Community Medical Clinic

  • 210 GOVERNMENT RD

    MATTAWA, WA 993495116

    Phone: (509) 932-4499

    Fax: (509) 932-5363

    Type: Mailing

  • 206 GOVERNMENT RD

    MATTAWA, WA 993495116

    Phone: (509) 932-4499

    Fax: (509) 932-5363

    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: 2024-07-10

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
O20240710000864OFederally Qualified Health Center (Fqhc)WATBD

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 99349)

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Reviews

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Frequently asked questions

Is Mattawa Community Medical Clinic listed with a National Provider Identifier?
Yes — Mattawa Community Medical Clinic has NPI 1013743210 on file in the registry.
Is Mattawa Community Medical Clinic shown as active in public data?
Registry records indicate Mattawa Community Medical Clinic maintains an active NPI.
What expertise is attributed to Mattawa Community Medical Clinic?
Mattawa Community Medical Clinic's specialty line reads Federally Qualified Health Center (FQHC). Clinical services aligned with this taxonomy classification.
What locale is associated with Mattawa Community Medical Clinic?
Directory geography for Mattawa Community Medical Clinic centers on Mattawa, Washington.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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