Ico Primary Care, Llc in Choctaw, OK - Medicare Clinic/Center

Ico Primary Care, Llc is a medicare enrolled primary clinic (Clinic/center - Primary Care) in Choctaw, Oklahoma. The current practice location for Ico Primary Care, Llc is 1664 S Choctaw Rd Ste 101, Choctaw, Oklahoma. For appointments, you can reach them via phone at (405) 281-2144. The mailing address for Ico Primary Care, Llc is 5701 Se 74th St Ste E, Oklahoma City, Oklahoma and phone number is (405) 600-6869.

Ico Primary Care, Llc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1568144996. 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 (405) 281-2144.

Contact Information

	Ico Primary Care, Llc
	1664 S Choctaw Rd Ste 101 Choctaw OK 73020-6767
	(405) 281-2144
	Not Available

Map and Direction

Primary Care Clinic Profile

Full Name	Ico Primary Care, Llc
Speciality	Clinic/Center
Location	1664 S Choctaw Rd Ste 101, Choctaw, Oklahoma
Authorized Official Name and Position	Kevin Penwell (CMO)
Authorized Official Contact	4056006869
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Ico Primary Care, Llc 5701 Se 74th St Ste E Oklahoma City OK 73135-1110 Ph: (405) 600-6869	Ico Primary Care, Llc 1664 S Choctaw Rd Ste 101 Choctaw OK 73020-6767 Ph: (405) 281-2144

NPI Details:

NPI Number	1568144996
Provider Enumeration Date	08/04/2023
Last Update Date	06/18/2024

Medicare PECOS Information:

Medicare PECOS PAC ID	6901240910
Medicare Enrollment ID	O20240219000460

Medical Identifiers

Medical identifiers for Ico Primary Care, Llc such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1568144996	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
261QP2300X	Clinic/center - Primary Care	(* (Not Available))	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Ico Primary Care, Llc acts as a billing entity for following providers:

Provider Name	Kevin M Penwell
Provider Type	Practitioner - Emergency Medicine
Provider Identifiers	NPI Number: 1841286333 PECOS PAC ID: 8325005580 Enrollment ID: I20041220000487

Provider Name	Richard D Brock
Provider Type	Practitioner - Family Practice
Provider Identifiers	NPI Number: 1437131695 PECOS PAC ID: 1658459359 Enrollment ID: I20080422000218

Reviews and Comments

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Ico Primary Care, Llc - Medicare Primary Care in Choctaw, OK