19th Avenue Operations, LLC
NPI 1649627423ActiveOrganization· Skilled Nursing Facility· Phoenix, AZ
Skilled Nursing Facility in Phoenix, Arizona, registered in NPPES in May 2016. The authorized official on file is Tracy L. Clark, Authorized Representative.
Overview
| NPI | 1649627423 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 20, 2016 |
| Last updated in NPPES | Jan 4, 2017 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Skilled Nursing Facility Primary | 314000000X | NCI-2694 | AZ |
| Assisted Living Facility | 310400000X | AL10014C | AZ |
| Assisted Living Facility | 310400000X | AL10013C | AZ |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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