NPIMap

Organization Active NPI

El Rio Santa Cruz Neighborhood Health Center, Inc

Doing business as El Rio Community Health Center-Southeast

  • Federally Qualified Health Center (FQHC)
  • Tucson, AZ
National Provider Identifier
1033400205
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
OTC4681 Issued in AZ
Legal business name
EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER, INC
Doing business as
El Rio Community Health Center-Southeast
Practice address
6950 E Golf Links Rd
Tucson, AZ 85730-1017
Phone
(520) 309-3210
NPI assigned
Apr 22, 2011
Last updated
Mar 2, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 2, 2023

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

Authorized official

Name
Clinton Kuntz
Title
Ceo
Phone
(520) 309-2012

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X OTC4681 AZ Primary

Addresses

Primary practice location

6950 E Golf Links Rd
Tucson, AZ 85730-1017

Mailing address

PO Box 1231
Tucson, AZ 85702-1231
Phone (520) 670-3909

Other identifiers 1

IdentifierTypeStateIssuer
947895MedicaidAZ

Other names 1

  • EL RIO COMMUNITY HEALTH CENTER-SOUTHEAST Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110901000233 AZ Part A Provider - Federally Qualified Health Center (FQHC) 6305739244 Practice locations: Tucson, AZ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1033400205. Details of each certification follow.

Federally qualified health center certification: CCN 031894

Legal name
EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER, INC.
Doing business as
EL RIO COMMUNITY HEALTH CENTER-SOUTHEAST
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 21, 2011
Last certification
Sep 21, 2011
Ownership / control type
Non-profit – church related
Organization structure
CorporationNon-profit
Incorporated
Mar 5, 1973 in AZ
Enrollment address
6950 E Golf Links Rd
Tucson, AZ 85730-1017

Other NPIs with the same Medicare PAC ID 16

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

View all 16

National Provider Directory

National Provider Directory
Tax ID family
El Rio OBGYN Associates59 organizations share this tax ID, including this one
Part of
El Rio OBGYN Associates

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

1230 S Cherrybell Stra
Tucson, AZ 85713
Phone (520) 205-4997

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Miguel Rojas Individual Corporate Director Apr 19, 2011
Kirk Saunders Individual Corporate Director Apr 19, 2011
Enrique Serna Individual Corporate Director Apr 19, 2011
Gail Roberts Individual Corporate Director Apr 19, 2011
Cecilia Cruce Individual W-2 Managing EmployeeRevenue Cycle Manager Aug 31, 2015
Barbara Soehnlen Individual Corporate Director Apr 19, 2011
Patricia Solis Individual Corporate Director Apr 19, 2011
Stephen Eggen Individual Corporate Director Apr 19, 2011
Douglas J Spegman Individual Corporate OfficerChief Clinical Officer Aug 1, 1994
W-2 Managing EmployeeChief Clinical Officer Aug 1, 1994
El Rio Santa Cruz Neighborhood Health Center, Inc. Organization, Tucson, AZ Operational/Managerial Control Mar 31, 2011
Frank Valenzuela Individual Corporate Director Apr 19, 2011
Brian Flagg Individual Corporate Director Apr 19, 2011
Michael T Odum Individual Corporate Director Apr 19, 2011

Owners & managing parties with NPI records 17

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

View all 17

All facility ownership & control disclosures 9

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

FacilityTypeRoleSince
El Rio Community Health CenterTucson, AZ, CCN 031801 Federally qualified health center Operational/Managerial Control Sep 30, 2010
El Rio OB/GYN AssociatesTucson, AZ, CCN 031895 Federally qualified health center Operational/Managerial Control Mar 31, 2011
El Pueblo Health CenterTucson, AZ, CCN 031892 Federally qualified health center Operational/Managerial Control Mar 31, 2011
El Rio Northwest Health CenterTucson, AZ, CCN 031899 Federally qualified health center Operational/Managerial Control Mar 31, 2011
El Rio Southwest Health CenterTucson, AZ, CCN 031897 Federally qualified health center Operational/Managerial Control Mar 31, 2011
El Rio Pascua YaquiTucson, AZ, CCN 031917 Federally qualified health center Operational/Managerial Control Oct 1, 1980
Health on BroadwayTucson, AZ, CCN 031945 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2017
El Rio Health CherrybellTucson, AZ, CCN 031984 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Feb 18, 2019
Health on UniversityTucson, AZ, CCN 031987 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Dec 10, 2019

Owned or controlled facilities with NPI records 9

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

Facilities with the same owner 9

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": "1303430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677715200000",
    "number": "1033400205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1231",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857021231",
            "telephone_number": "520-670-3909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6950 E GOLF LINKS RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857301017",
            "telephone_number": "520-309-3210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER, INC",
        "enumeration_date": "2011-04-22",
        "last_updated": "2023-03-02",
        "certification_date": "2022-05-12",
        "status": "A",
        "authorized_official_last_name": "KUNTZ",
        "authorized_official_first_name": "CLINTON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "520-309-2012"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "AZ",
            "license": "OTC4681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "947895",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EL RIO COMMUNITY HEALTH CENTER-SOUTHEAST",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "EL RIO COMMUNITY HEALTH CENTER-SOUTHEAST",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.