Tri State Primary Care - Medicare Primary Care in Fort Mohave, AZ

Tri State Primary Care is a medicare enrolled primary clinic (Internal Medicine) in Fort Mohave, Arizona. The current practice location for Tri State Primary Care is 1510 E Wagon Wheel Ln Ste 104, Fort Mohave, Arizona. For appointments, you can reach them via phone at (928) 248-0518. The mailing address for Tri State Primary Care is 1510 E Wagon Wheel Ln Ste 104, Fort Mohave, Arizona and phone number is (928) 248-0518.

Tri State Primary Care is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1669146536. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (928) 248-0518.

Contact Information

Tri State Primary Care
1510 E Wagon Wheel Ln Ste 104
Fort Mohave
AZ 86426-6698
(928) 248-0518
(928) 514-2823

Map and Direction


Primary Care Clinic Profile

Full NameTri State Primary Care
SpecialityInternal Medicine
Location1510 E Wagon Wheel Ln Ste 104, Fort Mohave, Arizona
Authorized Official Name and PositionWantzy Cooper (PRESIDENT)
Authorized Official Contact9282480518
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Tri State Primary Care
1510 E Wagon Wheel Ln Ste 104
Fort Mohave
AZ 86426-6698

Ph: (928) 248-0518
Tri State Primary Care
1510 E Wagon Wheel Ln Ste 104
Fort Mohave
AZ 86426-6698

Ph: (928) 248-0518

NPI Details:

NPI Number1669146536
Provider Enumeration Date08/04/2021
Last Update Date03/04/2024

Medicare PECOS Information:

Medicare PECOS PAC ID2668863200
Medicare Enrollment IDO20240227004341

Medical Identifiers

Medical identifiers for Tri State Primary Care such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1669146536NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine (* (Not Available))Primary
261QP2300XClinic/center - Primary Care (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Tri State Primary Care acts as a billing entity for following providers:
Provider NameGuillermo G Zegarra
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1568478493
PECOS PAC ID: 1456391564
Enrollment ID: I20050509000540
Provider NameWantzy Cooper
Provider TypePractitioner - Vascular Surgery
Provider IdentifiersNPI Number: 1942383393
PECOS PAC ID: 6002815214
Enrollment ID: I20110208000789
Provider NameJohn Adan
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1295709665
PECOS PAC ID: 5799747002
Enrollment ID: I20141114000312

Reviews and Comments


Internal Medicine in Fort Mohave, AZ

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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.