NPIMap

Organization Active NPI

El Centro Regional Medical Center

Doing business as ECRMC Outpatient Clinic

  • Rural Health Clinic/Center
  • El Centro, CA
National Provider Identifier
1144300476
Registry record updated Feb 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
EL CENTRO REGIONAL MEDICAL CENTER
Doing business as
ECRMC Outpatient Clinic
El Centro Outpatient Center
Practice address
385 W Main St
El Centro, CA 92243-3040
Phone
(760) 482-9100
NPI assigned
Oct 17, 2006
Last updated
Feb 7, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2019

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

Authorized official

Name
Tisha Irene Benavidez
Title
Patient Financial Services Director
Phone
(760) 482-5334

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

385 W Main St
El Centro, CA 92243-3040

Mailing address

1415 Ross Ave
El Centro, CA 92243-4306
Phone (760) 339-7495

Other identifiers 1

IdentifierTypeStateIssuer
RHM18518FMedicaidCA

Other names 2

  • ECRMC Outpatient Clinic Doing business as
  • EL CENTRO OUTPATIENT CENTER Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100510000447 CA Part A Provider - Rural Health Clinic 6901986397 Practice locations: El Centro, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1144300476. Details of each certification follow.

Rural health clinic certification: CCN 058518

Legal name
EL CENTRO REGIONAL MEDICAL CENTER
Doing business as
EL CENTRO OUTPATIENT CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 17, 1995
Last certification
Jun 17, 2015
Ownership / control type
Non-profit – church related
Organization structure
GovernmentNon-profit
Enrollment address
385 W Main St
El Centro, CA 92243-3040
Related CCNs
050045

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
El Centro Hosp Phcy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Virgnia Torres Individual Corporate DirectorPatient Accounting Director Jul 1, 2022
W-2 Managing EmployeePatient Accounting Director Oct 16, 2016
Regents of the University of California Organization, San Diego, CA Corporation, Non-profit Operational/Managerial Control Jan 1, 2016 100%
Pablo Velez Individual Corporate OfficerChief Executive Officer May 1, 2023 100%

Owners & managing parties with NPI records 9

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

Facilities with the same owner 4

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549497600000",
    "number": "1144300476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 ROSS AVE",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922434306",
            "telephone_number": "760-339-7495",
            "fax_number": "760-339-7389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 W MAIN ST",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922433040",
            "telephone_number": "760-482-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EL CENTRO REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2019-02-07",
        "status": "A",
        "authorized_official_last_name": "BENAVIDEZ",
        "authorized_official_first_name": "TISHA",
        "authorized_official_middle_name": "IRENE",
        "authorized_official_title_or_position": "PATIENT FINANCIAL SERVICES DIRECTOR",
        "authorized_official_telephone_number": "760-482-5334"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM18518F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ECRMC Outpatient Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "EL CENTRO OUTPATIENT CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in El Centro, CA

Sources for this page

Verify at the official NPI Registry.