PACE Agencies PACE Provider 50 CARE-ELD) 5P PACE 251T00000X Organization Ambulance AMBULANCE Service Supplier, Transportation 51 59 Private 341600000X Services/Ambulance CCN-S CO-ORDIN Care CARE Network, Shared Managed Care Organizations 52 5R Savings) 302R00000X Health Maintenance Organization SELF Other Service Providers 53 SUPPORT NULL 172V00000X Community Health Worker Clinic or Ambulatory Health Care SURGI CTR Other Group Facilities/Clinic-Center, 54 (IN-ST) 70 Practice 261QA1903X Ambulatory Surgical EMERG ACCESS Hospitals Ambulatory Health Care HOSPITAL and Nursing Facilities Clinic/Center Critical 55 (IN-ST) 86 Homes 261QC0050X Access Hospital PRESCRIBER ONLY FOR 56 MCO NULL NA NULL Public OPH Health or REGISTERED Welfare NURSE Agencies & Nursing Service Providers 57 60 Clinics 163W00000X Registered Nurse NOT 58 ASSIGNED NULL NA NULL LTX_Prov_ Specialty_ Desc LTX_Taxonomy_Desc NEURO REHAB Hospitals HOSPITAL and Nursing Hospital Units/Rehabilitation 59 (IN-ST) 86 Homes 273Y00000X Unit Extended Care Hospitals/General Acute Care 60 HOSPITAL 85 Hospital 282N00000X Hospital Hospitals and Nursing Hospitals/General Acute Care 60 HOSPITAL 86 Homes 282N00000X Hospital Hospitals/General Acute Care 60 HOSPITAL 87 All Other 282N00000X Hospital
50 PACE CARE-ELD) 5P PACE 251T00000X Agencies PACE Provider Organization 51 AMBULANCE 59 Ambulance Service Supplier, Private 341600000X Transportation Services/Ambulance 52 CO-ORDIN CARE 5R CCN-S Care Network, Shared Savings) 302R00000X Managed Care Organizations Health Maintenance Organization 53 SELF SUPPORT NULL 172V00000X Other Service Providers Community Health Worker 54 SURGI CTR (IN-ST) 70 Clinic or Other Group Practice 261QA1903X Ambulatory Health Care Facilities/Clinic-Center, Ambulatory Surgical 55 EMERG ACCESS HOSPITAL (IN-ST) 86 Hospitals and Nursing Homes 261QC0050X Ambulatory Health Care Facilities Clinic/Center Critical Access Hospital 56 PRESCRIBER ONLY FOR MCO NULL NA NULL 57 OPH REGISTERED NURSE 60 Public Health or Welfare Agencies & Clinics 163W00000X Nursing Service Providers Registered Nurse 58 NOT ASSIGNED NULL NA NULL LTX_Prov_ Specialty_ Desc LTX_Taxonomy_Desc 59 NEURO REHAB HOSPITAL (IN-ST) 86 Hospitals and Nursing Homes 273Y00000X Hospital Units/Rehabilitation Unit 60 HOSPITAL 85 Extended Care Hospital 282N00000X Hospitals/General Acute Care Hospital 60 HOSPITAL 86 Hospitals and Nursing Homes 282N00000X Hospitals/General Acute Care Hospital 60 HOSPITAL 87 All Other 282N00000X Hospitals/General Acute Care Hospital
PIHP_CSoC_SystemsCompanionGuide-Sept2018_V12.docx