NPIMap

Organization Active NPI

SHC Medical Center Toppenish

Doing business as Astria Health Center

  • Rural Health Clinic/Center
  • Union Gap, WA
National Provider Identifier
1013492784
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SHC MEDICAL CENTER TOPPENISH
Doing business as
Astria Health Center
Practice address
1420 Ahtanum Ridge Dr
Union Gap, WA 98903-1839
Phone
(509) 454-7700
Fax
(509) 454-7710
NPI assigned
Sep 28, 2018
Last updated
Oct 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Authorized official

Name
Mathew Mathiesen
Title
Ceo
Phone
(509) 837-1364

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

1420 Ahtanum Ridge Dr
Union Gap, WA 98903-1839

Mailing address

PO Box 719
Sunnyside, WA 98944-0719
Phone (509) 454-7700

Other names 1

  • Astria Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20171018001921 WA Part B Supplier - Hospital Department(S) 4082980065 Receives reassigned benefits from 81 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Toppenish, WA; Union Gap, WA; Yakima, WA; Zillah, WA
O20190102003109 WA Part A Provider - Rural Health Clinic 4082980065 Practice locations: Union Gap, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013492784. Details of each certification follow.

Rural health clinic certification: CCN 508586

Legal name
SHC MEDICAL CENTER TOPPENISH
Doing business as
ASTRIA HEALTH CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 18, 2019
Last certification
Jun 18, 2019
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
1420 Ahtanum Ridge Dr
Union Gap, WA 98903-1839
Related CCNs
500037

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory

Locations

1806 Yakima Valley Hwy
Ste B
Sunnyside, WA 98944

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Bertha Ortega Individual Corporate OfficerChairperson Jan 1, 2021
SHC Holdco LLC Organization, Sunnyside, WA LLC, Non-profit 5% Or Greater Direct Ownership Interest Sep 1, 2017 100%
Operational/Managerial Control Sep 1, 2017 100%
Brian P Gibbons Individual Corporate DirectorPresident & Ceo Jun 1, 2024
W-2 Managing EmployeePresident & Ceo Jun 1, 2024
Matthew Mathiesen Individual Corporate DirectorChief Financial Officer Jun 1, 2024
W-2 Managing EmployeeChief Financial Officer Jun 1, 2024
Carrie Story Individual Corporate OfficerVice Chairperson Jan 1, 2021
Maxine Janis Individual Corporate OfficerBoard Member Jan 1, 2021
Catherine Bambrick Individual Corporate Officer Jan 1, 2021
Steven Young Individual Corporate OfficerBoard Member Jan 1, 2021
Maxwell Owens Individual Corporate OfficerCfo Jan 1, 2020
Corporate DirectorCfo Jan 1, 2020
W-2 Managing EmployeeCfo Jan 1, 2020
Astria Health Organization, Yakima, WA Corporation, For-profit, Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest Sep 1, 2017 100%
Operational/Managerial Control Sep 1, 2017 100%
Other Dec 1, 2018

Facilities with the same owner 12

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

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1538092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727913600000",
    "number": "1013492784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 719",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989440719",
            "telephone_number": "509-454-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 AHTANUM RIDGE DR",
            "city": "UNION GAP",
            "state": "WA",
            "postal_code": "989031839",
            "telephone_number": "509-454-7700",
            "fax_number": "509-454-7710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHC MEDICAL CENTER TOPPENISH",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-28",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A",
        "authorized_official_last_name": "MATHIESEN",
        "authorized_official_first_name": "MATHEW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-837-1364"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Astria Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Astria Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Union Gap, WA

Sources for this page

Verify at the official NPI Registry.