Pinedale Medical Clinic - Medicare Primary Care in Pinedale, WY

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Pinedale Medical Clinic is a medicare enrolled primary clinic (Family Medicine) in Pinedale, Wyoming. The current practice location for Pinedale Medical Clinic is 625 E Hennick St, Pinedale, Wyoming. For appointments, you can reach them via phone at (307) 367-4133. The mailing address for Pinedale Medical Clinic is Po Box 627, Pinedale, Wyoming and phone number is (307) 367-0021.

Pinedale Medical Clinic is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1104410596. 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 (307) 367-4133.

Contact Information

Pinedale Medical Clinic
625 E Hennick St
Pinedale
WY 82941-5228
(307) 367-4133
Not Available

Map and Direction


Primary Care Clinic Profile

Full NamePinedale Medical Clinic
SpecialityFamily Medicine
Location625 E Hennick St, Pinedale, Wyoming
Authorized Official Name and PositionKelli Ann Lovell (BUSINESS OFFICE MANAGER)
Authorized Official Contact3073670021
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Pinedale Medical Clinic
Po Box 627
Pinedale
WY 82941-0627

Ph: (307) 367-0021		Pinedale Medical Clinic
625 E Hennick St
Pinedale
WY 82941-5228

Ph: (307) 367-4133

NPI Details:

NPI Number1104410596
Provider Enumeration Date02/25/2021
Last Update Date06/07/2023

Medicare PECOS Information:

Medicare PECOS PAC ID5496163461
Medicare Enrollment IDO20210518002474

Medical Identifiers

Medical identifiers for Pinedale Medical Clinic such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1104410596NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine (* (Not Available))Primary
261QU0200XClinic/center - Urgent 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. Pinedale Medical Clinic acts as a billing entity for following providers:
Provider NameStephen W Wallace
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1851379119
PECOS PAC ID: 7810895877
Enrollment ID: I20050330000894
Provider NameWilliam David Burnett
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1760579023
PECOS PAC ID: 6103808795
Enrollment ID: I20050708000732
Provider NameRex Emerson Wortham
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1679580492
PECOS PAC ID: 0749278760
Enrollment ID: I20070104000514
Provider NameJames P Demetriou
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1447298583
PECOS PAC ID: 3779550280
Enrollment ID: I20080415000568
Provider NameKeri L Hull
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1225409477
PECOS PAC ID: 6800199431
Enrollment ID: I20160114001870
Provider NameRenae Dorrity
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1629293055
PECOS PAC ID: 3971657768
Enrollment ID: I20171129003221
Provider NameRafael Hastey
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1871989665
PECOS PAC ID: 6305153362
Enrollment ID: I20220706000192
Provider NameAndras T. Eder
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1851603146
PECOS PAC ID: 7719359637
Enrollment ID: I20230727002443

Reviews and Comments


Family Medicine in Pinedale, WY

High Country Behavioral Health
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 24 Country Club Lane, Pinedale, WY 82941
Phone: 307-367-2111    Fax: 307-367-2166
Pinedale Medical Clinic
Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 625 E Hennick, Pinedale, WY 82941
Phone: 307-367-4133    Fax: 307-367-6636
High Country Behavioral Health
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 24 Country Club Lane, Pinedale, WY 82941
Phone: 307-367-2111    Fax: 307-367-2166

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.