ALAGA HEALTH CHRONIC CARE MANAGEMENT LLC — NPI 1215631205 (Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center in PRESCOTT, AZ)

CMS-1500 Box 24J / 33a • NPI

1215631205

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

261QH0100X

Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center

Box 32 Service Location & ZIP+4

3250 GATEWAY BLVD STE 110, PRESCOTT, AZ, 86303-6846

✓ 9-Digit EDI 837 ZIP+4 (86303-6846)

Practice Phone & Referral Fax

(928) 350-7900

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1215631205 (ALAGA HEALTH CHRONIC CARE MANAGEMENT LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1215631205` (NPI-2 Organization / Facility)
Provider / Legal Name	ALAGA HEALTH CHRONIC CARE MANAGEMENT LLC
Plain-English Specialty	Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center NUCC Code: `261QH0100X` (Clinic/Center, Health Services)
Certifying / Licensing Body	Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Practice Location Address	3250 GATEWAY BLVD STE 110, PRESCOTT, AZ, 86303-6846
Practice Telephone / Fax	Tel: (928) 350-7900
Administrative Mailing Address	PO BOX 522, HUMBOLDT, AZ, 86329-0522
Enumeration & Last Sync	Enumerated: 2023-03-27 \| CMS Record Updated: 2024-01-31
Authorized Official	JOHN MICHAEL MATA (Administrator)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

3250 GATEWAY BLVD STE 110, PRESCOTT, AZ, 86303-6846

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Plain-English Taxonomy & CMS Crosswalk (261QH0100X)

What Does Taxonomy Code 261QH0100X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 261QH0100X translates to:
"Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Clinical Scope: Same-day outpatient consultations, urgent walk-in medical care, vaccinations, and day-case diagnostic procedures.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ALAGA HEALTH CHRONIC CARE MANAGEMENT LLC)

Typical CPT / Diagnostic Procedures:

Walk-In Urgent Care Evaluation, Point-of-Care Testing & X-Ray
Same-Day Ambulatory Endoscopy, Cataract & Minor Surgical Procedures

Common Therapeutic Classes:

Outpatient Oral Antimicrobials, Analgesics, Nebulizers & Vaccines

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`1835P2201X` — Pharmacist, Ambulatory Care Plain English: Licensed & Credentialed Pharmacist, Ambulatory Care	State: N/A \| License: `Verified` \| Primary: Secondary
`261Q00000X` — Clinic/Center Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: N/A \| License: `Verified` \| Primary: Secondary
`363L00000X` — Nurse Practitioner Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner	State: N/A \| License: `Verified` \| Primary: Secondary
`363LA2200X` — Nurse Practitioner, Adult Health Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Adult Health	State: N/A \| License: `Verified` \| Primary: Secondary
`363LG0600X` — Nurse Practitioner, Gerontology Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Gerontology	State: N/A \| License: `Verified` \| Primary: Secondary
`363LP2300X` — Nurse Practitioner, Primary Care Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Primary Care	State: N/A \| License: `Verified` \| Primary: Secondary
`261QH0100X` — Clinic/Center, Health Services Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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ALAGA HEALTH CHRONIC CARE MANAGEMENT LLC (NPI #1215631205)