NPIMap

Organization Active NPI

Virginia Garcia Memorial Health Center

  • Federally Qualified Health Center (FQHC)
  • Hillsboro, OR
National Provider Identifier
1003253048
Registry record updated Aug 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
VIRGINIA GARCIA MEMORIAL HEALTH CENTER
Practice address
971 SW Walnut St
Hillsboro, OR 97123-5651
Phone
(971) 281-3000
Fax
(503) 352-8658
NPI assigned
May 31, 2013
Last updated
Aug 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Annmarie Dennis
Title
Corporate Compliance Officer
Phone
(503) 214-1652

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

971 SW Walnut St
Hillsboro, OR 97123-5651

Mailing address

PO Box 6149
Aloha, OR 97007-0149
Phone (503) 640-5297

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031211000992 OR Part B Supplier - Clinic/Group Practice 7113823881 Receives reassigned benefits from 168 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Willamina, OR; Beaverton, OR; Sheridan, OR; Newberg, OR; McMinnville, OR; Hillsboro, OR; Cornelius, OR
O20140501000694 OR Part A Provider - Federally Qualified Health Center (FQHC) 7113823881 Practice locations: Hillsboro, OR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003253048. Details of each certification follow.

Federally qualified health center certification: CCN 381956

Legal name
VIRGINIA GARCIA MEMORIAL HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 5, 2014
Last certification
May 5, 2014
Ownership / control type
Non-profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 31, 1978 in OR
Enrollment address
971 SW Walnut Street
Hillsboro, OR 97123-5651

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Susan Felstiner Individual Corporate DirectorBoard Member Oct 23, 2013
Jessica Ann Kitt Individual Corporate DirectorBoard Member Aug 23, 2017
Gilles Martin Munoz Individual Corporate OfficerCeo Aug 5, 2005
Rafal Decker Individual Corporate DirectorBoard Member Jun 24, 2015
Joaquin Borrego Individual Corporate Director Sep 23, 2020
Michael Yates Individual Corporate Director Jul 24, 2019
Alejandra Aguilar Individual Corporate DirectorBoard Member Aug 1, 2010
Araceli Gaytan Individual W-2 Managing EmployeeChief Financial Officer Jul 18, 2007
Mark Millan Individual W-2 Managing EmployeeCoo Sep 20, 2021
Virginia Garcia Memorial Health Center Organization, Hillsboro, OR Non-profit Operational/Managerial Control Feb 28, 2014
Ricardo Palazuelos Individual Corporate DirectorChair Oct 23, 2013
Laurel Durham Individual Corporate DirectorSecretary Feb 28, 2018
Laurinda Mackenzie Individual Corporate DirectorBoard Member Sep 1, 2011
Mary Ludlum Individual Corporate DirectorVice Chair Mar 25, 2020

Owners & managing parties with NPI records 9

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Virginia Garcia Memorial Health CenterNewberg, OR, CCN 381947 Federally qualified health center Operational/Managerial Control Feb 28, 2014
Virginia Garcia Memorial Health CenterHillsboro, OR, CCN 381010 Federally qualified health center Operational/Managerial Control May 2, 2022

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1369958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692403200000",
    "number": "1003253048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6149",
            "city": "ALOHA",
            "state": "OR",
            "postal_code": "970070149",
            "telephone_number": "503-640-5297",
            "fax_number": "503-640-5780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 SW WALNUT ST",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971235651",
            "telephone_number": "971-281-3000",
            "fax_number": "503-352-8658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRGINIA GARCIA MEMORIAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-31",
        "last_updated": "2023-08-19",
        "certification_date": "2023-08-19",
        "status": "A",
        "authorized_official_last_name": "DENNIS",
        "authorized_official_first_name": "ANNMARIE",
        "authorized_official_title_or_position": "CORPORATE COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "503-214-1652"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

Verify at the official NPI Registry.