NPIMap

Organization Active NPI

M a C T Health Board, Incorporated

Doing business as MACT Optometry, Sonora

  • Clinic/Center
  • Sonora, CA
National Provider Identifier
1033898226
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
M A C T HEALTH BOARD, INCORPORATED
Doing business as
MACT Optometry, Sonora
Practice address
940 Sylva LN Ste H
Sonora, CA 95370-5969
Phone
(209) 754-6262
NPI assigned
Jul 14, 2023
Last updated
Jun 12, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
M A C T HEALTH BOARD, INCORPORATEDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Authorized official

Name
John Shawver Alexander
Title
Executive Director
Phone
(209) 754-6258

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU
Clinic/Center 261Q00000X NU Primary
Federally Qualified Health Center (FQHC) 261QF0400X NU
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

940 Sylva LN Ste H
Sonora, CA 95370-5969

Mailing address

PO Box 939
Angels Camp, CA 95222-0939
Phone (209) 754-6262

Other names 1

  • MACT Optometry, Sonora Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20240104002019 CA DME Supplier - Physician - Optometrist 8325936974 Practice locations: Sonora, CA
O20250902003184 CA Part A Provider - Federally Qualified Health Center (FQHC) 8325936974 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sonora, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1033898226. Details of each certification follow.

Federally qualified health center certification: CCN A01981

Legal name
M A C T HEALTH BOARD INCORPORATED
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 9, 2025
Last certification
May 9, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
940 Sylva LN
Ste H
Sonora, CA 95370-5969

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Part of
Mact Health Board Incorporated

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Justin Baugh Individual Corporate DirectorBoard Chair Jun 26, 2017
George Gurion Individual Corporate DirectorBoard Member Apr 22, 2023
Carolyn Sayers Individual Corporate OfficerBoard Secretary Jun 3, 2025
Mariela Contreras Individual Corporate DirectorExecutive Director May 6, 2026
W-2 Managing EmployeeExecutive Director Feb 2, 2015
Nancy Ehlers Individual Corporate DirectorBoard Member Jan 21, 2019
M a C T Health Board Incorporated Organization, Angels Camp, CA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Sep 21, 1979 100%

Owners & managing parties with NPI records 5

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

All facility ownership & control disclosures 13

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

FacilityTypeRoleSince
Mact Health Board IncSan Andreas, CA, CCN 051153 Federally qualified health center Operational/Managerial Control (100%) Apr 16, 2007
M a C T Health Board IncorporatedMariposa, CA, CCN 921022 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 27, 1999
M a C T Health Board IncorporatedJackson, CA, CCN 921021 Federally qualified health center Operational/Managerial Control (100%) Nov 1, 2016
M a C T Health Board IncorporatedSonora, CA, CCN 751981 Federally qualified health center Operational/Managerial Control (100%) Apr 16, 2007
Mact Medical, IoneIone, CA, CCN A01054 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2021
Mact Health & WellnessSonora, CA, CCN A01099 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Apr 8, 2022
Mact Women's Health CenterSonoro, CA, CCN A01832 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Sep 21, 1979
M a C T Health Board IncorporatedValley Springs, CA, CCN A01937 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Sep 21, 1979
M a C T Health Board IncorporatedSonora, CA, CCN A01981 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Sep 21, 1979
M a C T Health Board IncorporatedSutter Creek, CA, CCN A11044 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Sep 21, 1979
M a C T Health Board IncorporatedSonora, CA, CCN A11039 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Sep 21, 1979
M a C T Health Board IncorporatedSonora, CA, CCN A11038 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Sep 21, 1979
M a C T Health Board IncorporatedBear Valley, CA, CCN A11052 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Sep 21, 1979

Owned or controlled facilities with NPI records 11

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

NPI Registry JSON

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

{
    "created_epoch": "1689292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749686400000",
    "number": "1033898226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 939",
            "city": "ANGELS CAMP",
            "state": "CA",
            "postal_code": "952220939",
            "telephone_number": "209-754-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 SYLVA LN STE H",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953705969",
            "telephone_number": "209-754-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M A C T HEALTH BOARD, INCORPORATED",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "M A C T HEALTH BOARD, INCORPORATED",
        "enumeration_date": "2023-07-14",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "SHAWVER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "209-754-6258"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MACT Optometry, Sonora",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MACT Optometry, Sonora",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sonora, CA

Sources for this page

Verify at the official NPI Registry.