NPIMap

Organization Active NPI

Camarena Health

  • Federally Qualified Health Center (FQHC)
  • Madera, CA
National Provider Identifier
1124533492
Registry record updated May 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CAMARENA HEALTH
Practice address
705 W Pecan Ave
Madera, CA 93637-6254
Phone
(559) 664-4000
NPI assigned
Dec 8, 2017
Last updated
May 11, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
CAMARENA HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 11, 2018

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

Authorized official

Name
Luzvinda Gabriela Martinez
Title
Billing Supervisor
Phone
(559) 664-4000

Specialties & licenses 1

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

Addresses

Primary practice location

705 W Pecan Ave
Madera, CA 93637-6254

Mailing address

PO Box 299
Madera, CA 93639-0299
Phone (559) 664-4000

Other names 1

  • Camarena Health Madera South HIgh School: SBHC Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040318000523 CA Part B Supplier - Clinic/Group Practice 4880584317 Receives reassigned benefits from 178 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Oakhurst, CA; Madera, CA; Fresno, CA; Coarsegold, CA; Chowchilla, CA
O20180612000691 CA Part A Provider - Federally Qualified Health Center (FQHC) 4880584317 Practice locations: Madera, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1124533492. Details of each certification follow.

Federally qualified health center certification: CCN 921074

Legal name
CAMARENA HEALTH
Doing business as
CAMARENA HEALTH MADERA SOUTH HIGH SCHOOL: SBHC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 31, 2018
Last certification
May 31, 2018
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 21, 1978 in CA
Enrollment address
705 W Pecan Ave
Madera, CA 93637-6254

Other NPIs with the same Medicare PAC ID 23

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

View all 23

Other NPIs on the same Medicare enrollment 16

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

View all 16

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
05D2145228Camarena Health-SBHC705 West Pecan Avenue, Madera, CA 93637Certificate of waiverMar 2, 2028

National Provider Directory

National Provider Directory
Tax ID family
Darin M Camarena Health26 organizations share this tax ID, including this one
Part of
Darin M Camarena Health

Other organizations with this tax ID 25

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

View all 25

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Patty Thompson Individual Corporate DirectorBoard Member Nov 4, 2006
Martha Cardona Individual Corporate DirectorBoard Member Vice President May 23, 2018
Edgar Jimenez Individual Corporate DirectorBoard Member Jul 16, 2013
Paulo a Soares Individual Corporate OfficerChief Executive Officer Feb 1, 2011
Corporate DirectorChief Executive Officer Feb 1, 2011
Monic Asenjo-Wilhite Individual Corporate DirectorBoard Member President Jan 24, 2001
Seann Garcia Individual Corporate DirectorBoard Member Nov 16, 2011
Virginia M Lane-Pacheco Individual Corporate DirectorBoard Member Jan 1, 2025
Oracio M Rodriguez Individual Corporate DirectorBoard Member Jan 1, 2025
Abimael Vargas Individual Corporate DirectorBoard Member May 25, 2011
Christine N Howland Individual Corporate OfficerChief Operations Officer Apr 11, 2011 25%
W-2 Managing EmployeeChief Operations Officer Apr 11, 2011 25%
Raquel Rodarte Individual Corporate DirectorBoard Member Secretary Jan 1, 2015
Bruce Alamedia Individual Corporate DirectorBoard Treasurer Jan 1, 2022

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1512691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525996800000",
    "number": "1124533492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 299",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936390299",
            "telephone_number": "559-664-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 W PECAN AVE",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936376254",
            "telephone_number": "559-664-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMARENA HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAMARENA HEALTH",
        "enumeration_date": "2017-12-08",
        "last_updated": "2018-05-11",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "LUZVINDA",
        "authorized_official_middle_name": "GABRIELA",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "559-664-4000"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Camarena Health Madera South HIgh School: SBHC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Madera, CA

Sources for this page

Verify at the official NPI Registry.