NPIMap

Organization Active NPI

Sac Health System

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
National Provider Identifier
1013935923
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SAC HEALTH SYSTEM
Practice address
1293 N D St
San Bernardino, CA 92405-4734
Phone
(909) 382-7100
Fax
(909) 382-7101
NPI assigned
Jul 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Authorized official

Name
Tasha Amick
Title
Director of Billing
Phone
(909) 382-7100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X CMM70885F CA
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1293 N D St
San Bernardino, CA 92405-4734

Mailing address

1454 E 2ND St
San Bernardino, CA 92408-0118
Phone (909) 382-7100

Other identifiers 3

IdentifierTypeStateIssuer
EAP70708FOtherCAEAPC
ENVOY3000OtherCAENVOY
CMM70885FMedicaidCA

Other names 1

  • SAC Arrowhead Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040315000608 CA Part B Supplier - Clinic/Group Practice 4385533579 Receives reassigned benefits from 461 practitioners
9 other NPIs on this enrollment
Practice locations: Indio, CA; Murrieta, CA; Rialto, CA; San Bernardino, CA

Other NPIs with the same Medicare PAC ID 12

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

Other NPIs on the same Medicare enrollment 9

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 490

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 490

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745193600000",
    "number": "1013935923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1454 E 2ND ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924080118",
            "telephone_number": "909-382-7100",
            "fax_number": "909-382-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1293 N D ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924054734",
            "telephone_number": "909-382-7100",
            "fax_number": "909-382-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAC HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A",
        "authorized_official_last_name": "AMICK",
        "authorized_official_first_name": "TASHA",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING",
        "authorized_official_telephone_number": "909-382-7100"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "CA",
            "license": "CMM70885F",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EAPC",
            "identifier": "EAP70708F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ENVOY",
            "identifier": "ENVOY3000",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CMM70885F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAC Arrowhead",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SAC Arrowhead",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.