| Tonto Apache Healthcare LLC | |
|
40 Tonto Apache Reservation Payson AZ 85541-5556 | |
| (928) 474-5000 | |
| Not Available |
| Full Name | Tonto Apache Healthcare LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 40 Tonto Apache Reservation, Payson, Arizona |
| Authorized Official Name and Position | Lisa Carrasco (ADMINISTRATOR) |
| Authorized Official Contact | 9284723906 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tonto Apache Healthcare LLC 40 Tonto Apache Reservation Payson AZ 85541 Ph: (928) 472-3906 | Tonto Apache Healthcare LLC 40 Tonto Apache Reservation Payson AZ 85541-5556 Ph: (928) 474-5000 |
| NPI Number | 1447843651 |
|---|---|
| Provider Enumeration Date | 02/18/2021 |
| Last Update Date | 08/26/2025 |
| Certification Date | 07/23/2025 |
| Medicare PECOS PAC ID | 8426420118 |
|---|---|
| Medicare Enrollment ID | O20240729001282 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447843651 | NPI | - | NPPES |
| Provider Name | Jessica L Balcom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205320777 PECOS PAC ID: 1850630815 Enrollment ID: I20190308001741 |
| Provider Name | Mackenzie Carter Froehle |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1356922025 PECOS PAC ID: 8921408105 Enrollment ID: I20210609001595 |
| Provider Name | Lisa Carrasco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952179962 PECOS PAC ID: 1557709656 Enrollment ID: I20240409002970 |
| Provider Name | Noel Altaha |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669944914 PECOS PAC ID: 4981190055 Enrollment ID: I20251229002278 |
| Provider Name | Octavia Bartmess |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548054000 PECOS PAC ID: 1951888445 Enrollment ID: I20260127002411 |
| Provider Name | Haleigh Marie Lefthand-hack |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497593180 PECOS PAC ID: 1850870072 Enrollment ID: I20260209001883 |
| Provider Name | Brandi Sweet |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518452218 PECOS PAC ID: 6002280187 Enrollment ID: I20260310001384 |
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