St. John Medical Center - PeaceHealth Medical Group – Multi-Specialty Clinic/Center, NPI 1720056187
Multi-Specialty Clinic/Center
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for St. John Medical Center - PeaceHealth Medical Group
Longview Post Office, Hillside Road, Longview Shops, Page Moss, Huyton, Liverpool, Liverpool City Region, England, L36 8BJ, United Kingdom
LONGVIEW, WA 986320302
Phone: (360) 414-2000
Fax: (360) 414-2054
Type: Mailing
PeaceHealth St. John Medical Center, 1615, Delaware Street, Longview, Cowlitz County, Washington, 98632, United States
LONGVIEW, WA 986322367
Phone: (360) 414-2000
Fax: (360) 414-2054
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: 2025-12-08
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 16 Medicare enrollment records; no due dates published yet.
Enrollment records
16
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 |
|---|---|---|---|---|
| O20040209000272 | O | Clinic/Group Practice | WA | TBD |
| O20250715003559 | O | Clinic/Group Practice | PA | TBD |
| O20250719000202 | O | Clinic/Group Practice | TX | TBD |
| O20250730000861 | O | Clinic/Group Practice | CO | TBD |
| O20250801000642 | O | Clinic/Group Practice | FL | TBD |
| O20250807000869 | O | Clinic/Group Practice | IN | TBD |
| O20250807002583 | O | Clinic/Group Practice | IA | TBD |
| O20250814003411 | O | Clinic/Group Practice | CA | TBD |
| O20250820000767 | O | Clinic/Group Practice | OH | TBD |
| O20250821001694 | O | Clinic/Group Practice | OR | TBD |
| O20250829000170 | O | Clinic/Group Practice | NC | TBD |
| O20250903004340 | O | Clinic/Group Practice | NV | TBD |
| O20250909004622 | O | Clinic/Group Practice | IL | TBD |
| O20250924002339 | O | Clinic/Group Practice | TN | TBD |
| O20251027000058 | O | Clinic/Group Practice | NY | TBD |
| O20251208003127 | O | Clinic/Group Practice | GA | 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 98632)
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