Camarena Health
Organization Active NPI Federally Qualified Health Center (FQHC) · Madera, CA
NPI 1124533492 · NPPES record last updated May 11, 2018
Key facts
- NPI
- 1124533492
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 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
- Organization subpart
- Yes
- Parent organization (as reported)
- CAMARENA HEALTH
Authorized official
- Name
- Luzvinda Gabriela Martinez
- Title
- Billing Supervisor
- Phone
- (559) 664-4000
Other NPIs on the same Medicare enrollment 16
Other NPIs with the same Medicare PAC ID 23
Corporate family (same tax ID) 22
Practitioners 87
-
Jack Douglas Clark, M.D.
-
Soledad Reyes, FNP-C
-
Naeem M. Akhtar, MD
-
Mohammad Ashraf, MD
-
Manjot Kaur Batth, O.D.
-
Kenneth Bernstein, M.D.
-
Asha Blades, DPM
-
Angelina Bravo, FNP-C
-
Erika Cano, FNP-C
-
Gabriel Carpio-Bracho, M.D.
-
Stephanie Castillo, FNP
-
Frank Paul Chimienti, P.A.
-
Ilsook Park Dahlin, FNP
-
David J Drake, MD
-
Daniel Duron, NP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2145228 | Camarena Health-SBHC | Certificate of waiver | Mar 2, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CA
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
- Corporation · Non-profit
- Incorporated
- Jul 21, 1978 in CA
- Enrollment address
- 705 W Pecan Ave
Madera, CA 93637-6254
All disclosed owners & managing parties 12
| Name | Role | Since | Share |
|---|---|---|---|
| Patty Thompson |
Corporate Director |
Nov 4, 2006 | |
| Martha Cardona |
Corporate Director |
May 23, 2018 | |
| Edgar Jimenez |
Corporate Director |
Jul 16, 2013 | |
| Paulo a Soares |
Corporate Officer |
Feb 1, 2011 | |
| Corporate Director |
Feb 1, 2011 | ||
| Monic Asenjo-Wilhite |
Corporate Director |
Jan 24, 2001 | |
| Seann Garcia |
Corporate Director |
Nov 16, 2011 | |
| Virginia M Lane-Pacheco |
Corporate Director |
Jan 1, 2025 | |
| Oracio M Rodriguez |
Corporate Director |
Jan 1, 2025 | |
| Abimael Vargas |
Corporate Director |
May 25, 2011 | |
| Christine N Howland |
Corporate Officer |
Apr 11, 2011 | 25% |
| W-2 Managing Employee |
Apr 11, 2011 | 25% | |
| Raquel Rodarte |
Corporate Director |
Jan 1, 2015 | |
| Bruce Alamedia |
Corporate Director |
Jan 1, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- Darin M Camarena HLTH C
- Part of
- Darin M Camarena HLTH C
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | CA | Yes |
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
- Camarena Health Madera South HIgh School: SBHC
Other providers in Madera, CA
- California Medical Imaging Associates, Inc
- Lynnlee Madisyn Cam
- Alma P Camacho
- Rosario Camacho
- Camarena Health
- Camarena Health
- Camarena Health
- Camarena Health
- Camarena Health
- Camarena Health
All providers in Madera, CA · Federally Qualified Health Center (FQHC) in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 11, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.