NPIMap

Organization Active NPI

Alameda Health System

Doing business as Hayward Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Hayward, CA
National Provider Identifier
1023219821
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
EXEMPT UNDER 12-35B Issued in CA
Legal business name
ALAMEDA HEALTH SYSTEM
Doing business as
Hayward Wellness Center
Practice address
664 Southland Mall
Hayward, CA 94545-2150
Phone
(510) 266-1700
Fax
(510) 782-8766
NPI assigned
May 30, 2007
Last updated
Apr 27, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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

Authorized official

Name
Kim Miranda
Title
Cfo
Phone
(510) 618-2147

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X EXEMPT UNDER 12-35B CA Primary
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

664 Southland Mall
Hayward, CA 94545-2150

Mailing address

15400 Foothill Blvd
San Leandro, CA 94578-1009
Phone (510) 895-7344

Other names 1

  • HAYWARD WELLNESS CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031110000764 CA Part B Supplier - Clinic/Group Practice 3779494521 Receives reassigned benefits from 973 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Alameda, CA; Castro Valley, CA; Hayward, CA; Newark, CA; Oakland, CA; San Leandro, CA

Other NPIs on the same Medicare enrollment 11

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 180

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 180

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651017600000",
    "number": "1023219821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15400 FOOTHILL BLVD",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945781009",
            "telephone_number": "510-895-7344",
            "fax_number": "510-895-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "664 SOUTHLAND MALL",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945452150",
            "telephone_number": "510-266-1700",
            "fax_number": "510-782-8766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALAMEDA HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A",
        "authorized_official_last_name": "MIRANDA",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "510-618-2147"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "EXEMPT UNDER 12-35B",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HAYWARD WELLNESS CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HAYWARD WELLNESS CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hayward, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; 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.