NPIMap

Organization Active NPI

Clinica de Salud del Valle de Salinas

  • Federally Qualified Health Center (FQHC)
  • Soledad, CA
National Provider Identifier
1053452136
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
070000277 Issued in CA
Legal business name
CLINICA DE SALUD DEL VALLE DE SALINAS
Practice address
799 Front St
Soledad, CA 93960-3017
Phone
(831) 678-0881
Fax
(831) 678-2803
NPI assigned
Feb 9, 2007
Last updated
Jun 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Authorized official

Name
Dr. Maximiliano Cuevas, M.D.
Title
Ceo
Phone
(831) 757-8689

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 070000277 CA Primary

Addresses

Primary practice location

799 Front St
Soledad, CA 93960-3017

Mailing address

55 Plaza Cir Ste a
Salinas, CA 93901-2952
Phone (831) 757-8689

Other identifiers 1

IdentifierTypeStateIssuer
FHC03913FMedicaidCA

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20081118000667 CA Part B Supplier - Clinic/Group Practice 3678513736 Receives reassigned benefits from 71 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Castroville, CA; Gonzales, CA; Greenfield, CA; King City, CA; Royal Oaks, CA; Salinas, CA; Soledad, CA
O20100623001009 CA Part A Provider - Federally Qualified Health Center (FQHC) 3678513736 Practice locations: Soledad, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1053452136. Details of each certification follow.

Federally qualified health center certification: CCN 051953

Legal name
CLINICA DE SALUD DEL VALLE DE SALINAS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 1, 1995
Last certification
Jul 1, 1995
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 9, 1980 in CA
Enrollment address
799 Front St
Soledad, CA 93960-3017

Other NPIs with the same Medicare PAC ID 9

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

Other NPIs on the same Medicare enrollment 11

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0937914Clinica de Salud del Valle de Salinas799 Front Street, Soledad, CA 93960Provider-performed microscopyDec 23, 2027

National Provider Directory

National Provider Directory
Tax ID family
Rafael O Siqueiros MD9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Maximiliano Cuevas Individual Corporate DirectorCeo Jan 1, 2015
Michael Victor Individual W-2 Managing Employee Jan 14, 2019
Ruben Jimenez Individual W-2 Managing Employee Sep 5, 2018
Jesus Lopez Individual Corporate Director Apr 5, 2012
Maria Villagomez Individual Operational/Managerial Control Oct 1, 2015
Rogelio Jacinto Individual Corporate Director Mar 2, 1998
Raymond Gonzalez Individual Corporate Director Mar 1, 2001
Maria Aguilar Individual Corporate Director Jun 5, 2008
Genaro Carlos Individual Corporate Director Mar 2, 1998
Victoria Coley Individual Corporate Director Feb 7, 2019
Ali Chavez Individual Corporate Director Mar 2, 1998
Elizabeth Reyes Individual Corporate Director Nov 15, 1999
Aurelio Gonzalez Individual Corporate Director Oct 7, 2010
Silvana Fiege Individual W-2 Managing Employee Jan 12, 2009
Josefina Rodriguez Individual Corporate Director Nov 15, 1999
Criselia Serrano Individual Corporate Director Mar 2, 1998

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
CSVS - Plaza CircleSalinas, CA, CCN A01118 Federally qualified health center Operational/Managerial Control Aug 1, 2022

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 4

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": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717632000000",
    "number": "1053452136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 PLAZA CIR STE A",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939012952",
            "telephone_number": "831-757-8689",
            "fax_number": "831-757-3721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "799 FRONT ST",
            "city": "SOLEDAD",
            "state": "CA",
            "postal_code": "939603017",
            "telephone_number": "831-678-0881",
            "fax_number": "831-678-2803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA DE SALUD DEL VALLE DE SALINAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A",
        "authorized_official_last_name": "CUEVAS",
        "authorized_official_first_name": "MAXIMILIANO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "831-757-8689",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "070000277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC03913F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Soledad, CA

Sources for this page

Verify at the official NPI Registry.