NPIMap

Organization Active NPI

Universal Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
National Provider Identifier
1093023277
Registry record updated Sep 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
UNIVERSAL COMMUNITY HEALTH CENTER
Practice address
1005 E Washington Blvd
Suite a
Los Angeles, CA 90021-3020
Phone
(213) 745-3636
NPI assigned
Sep 21, 2010
Last updated
Sep 18, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2019

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

Authorized official

Name
Edgar Alexander Chavez, MDNPI 1023216678
Title
Ceo
Phone
(323) 233-3100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Family Medicine Physician 207Q00000X CA

Addresses

Primary practice location

1005 E Washington Blvd
Suite a
Los Angeles, CA 90021-3020

Mailing address

1005 E Washington Blvd
Suite a
Los Angeles, CA 90021-3020
Phone (323) 233-3100

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110125000952 CA Part B Supplier - Clinic/Group Practice 0547449399 Receives reassigned benefits from 39 practitioners
6 other NPIs on this enrollment
Practice locations: Los Angeles, CA
O20120518000574 CA Part A Provider - Federally Qualified Health Center (FQHC) 0547449399 Practice locations: Los Angeles, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093023277. Details of each certification follow.

Federally qualified health center certification: CCN 551178

Legal name
UNIVERSAL COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 18, 2012
Last certification
May 18, 2012
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 28, 2009 in CA
Enrollment address
1005 E Washington Blvd
Suite a
Los Angeles, CA 90021-3020

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 6

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
05D2018239Universal Community Health Center1005 E Washington Blvd Ste a, Los Angeles, CA 90021Certificate of waiverDec 28, 2026

National Provider Directory

National Provider Directory

Locations

1005 E Washington Blvd
Ste A
Los Angeles, CA 90021
Phone (213) 745-3636

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DFGBDA

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Angelica Ramirez Individual Corporate DirectorBoard Member Mar 31, 2010
Ruth Catalan Individual Corporate OfficerBoard Member Mar 31, 2010
Kathleen Momii Individual Corporate DirectorBoard President Mar 31, 2010
Edgar a Chavez Individual Corporate OfficerCeo Mar 31, 2010
W-2 Managing EmployeeCeo Mar 31, 2010
Robert Montes Individual Corporate DirectorBoard Member Mar 31, 2010

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
Universal Community Health CenterLos Angeles, CA, CCN 921014 Federally qualified health center Operational/Managerial Control Jul 16, 2009

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 41

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 41

NPI Registry JSON

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

{
    "created_epoch": "1285027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568764800000",
    "number": "1093023277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 E WASHINGTON BLVD",
            "address_2": "SUITE A",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900213020",
            "telephone_number": "323-233-3100",
            "fax_number": "323-233-3124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 E WASHINGTON BLVD",
            "address_2": "SUITE A",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900213020",
            "telephone_number": "213-745-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSAL COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-21",
        "last_updated": "2019-09-18",
        "status": "A",
        "authorized_official_last_name": "CHAVEZ",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "323-233-3100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.