NPIMap

Organization Active NPI

La Esperanza Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • San Angelo, TX
National Provider Identifier
1043489347
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LA ESPERANZA CLINIC, INC.
Practice address
35 E 31St St
San Angelo, TX 76903-2207
Phone
(325) 944-8900
NPI assigned
Feb 21, 2008
Last updated
Jan 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Authorized official

Name
Rosie Castaneda
Title
Cfo
Phone
(325) 947-5623

Specialties & licenses 1

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

Addresses

Primary practice location

35 E 31St St
San Angelo, TX 76903-2207

Mailing address

2029 W Beauregard Ave
San Angelo, TX 76901-3812
Phone (325) 223-8129

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040415000585 TX Part B Supplier - Clinic/Group Practice 7416942933 Receives reassigned benefits from 26 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: San Angelo, TX
O20080520000633 TX Part A Provider - Federally Qualified Health Center (FQHC) 7416942933 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: San Angelo, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043489347. Details of each certification follow.

Federally qualified health center certification: CCN 671891

Legal name
LA ESPERANZA CLINIC INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 27, 2008
Last certification
Jun 27, 2008
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 1, 1994 in TX
Enrollment address
35E 31St St
San Angelo, TX 76903-2207

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

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
David Vessell Individual Corporate DirectorBoard President Jan 1, 2018
Rosa Castaneda Individual W-2 Managing EmployeeCfo May 13, 2013
Lauri Kirgis Individual Corporate DirectorBoard Secretary Jan 1, 2018
Louie Perez Individual Corporate DirectorBoard V-President Jun 1, 2018
Dean Munn Individual Corporate OfficerCeo Feb 4, 2019
W-2 Managing EmployeeCeo Feb 4, 2019
Stephen Franco Individual Corporate DirectorBoard Treasurer Jan 1, 2010

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1203552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704672000000",
    "number": "1043489347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2029 W BEAUREGARD AVE",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769013812",
            "telephone_number": "325-223-8129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 E 31ST ST",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769032207",
            "telephone_number": "325-944-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA ESPERANZA CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-21",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A",
        "authorized_official_last_name": "CASTANEDA",
        "authorized_official_first_name": "ROSIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "325-947-5623"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

Verify at the official NPI Registry.