NPIMap

Organization Active NPI

16TH Street Community Health Center Inc.

Doing business as Sixteenth Street Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Waukesha, WI
National Provider Identifier
1144593815
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
1507-800 Issued in WI
Legal business name
16TH STREET COMMUNITY HEALTH CENTER INC.
Doing business as
16th Street Community Health Center Inc.
Sixteenth Street Community Health Centers
Practice address
309 E North St
Waukesha, WI 53188-3718
Phone
(414) 672-1353
Fax
(262) 408-5094
NPI assigned
Feb 10, 2012
Last updated
Jan 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Authorized official

Name
Tanya M Stamps
Title
Chief Financial Officer
Phone
(414) 897-5407

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 1507-800 WI Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Multi-Specialty Clinic/Center 261QM1300X
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X
Advanced Practice Midwife 367A00000X
Counselor 101Y00000X
Psychologist 103T00000X
Social Worker 104100000X
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X
Obstetrics & Gynecology Physician 207V00000X
Pediatrics Physician 208000000X
Physical Therapist 225100000X

Addresses

Primary practice location

309 E North St
Waukesha, WI 53188-3718

Mailing address

PO Box 778789
Chicago, IL 60677-8789
Phone (414) 672-1353

Other identifiers 2

IdentifierTypeStateIssuer
100024527MedicaidWI
1144593815MedicaidWI

Other names 4

  • 16th Street Community Health Center Inc. Doing business as
  • Sixteenth Street Community Health Centers Doing business as
  • Sixteenth Street Community Health Center Inc. Former legal business name
  • Sixteenth Street Community Health Centers Inc Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040512001352 WI Part B Supplier - Clinic/Group Practice 6709876857 Receives reassigned benefits from 160 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Milwaukee, WI; Waukesha, WI
O20121212000285 WI Part A Provider - Federally Qualified Health Center (FQHC) 6709876857 Practice locations: Waukesha, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1144593815. Details of each certification follow.

Federally qualified health center certification: CCN 521847

Legal name
16TH STREET COMMUNITY HEALTH CENTER INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 28, 2013
Last certification
Jan 28, 2013
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Enrollment address
309 E North St
Waukesha, WI 53188-3718

Other NPIs with the same Medicare PAC ID 4

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.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Juan a Ruiz Individual Corporate DirectorBoard Member Aug 1, 2008
Ellen K Murphy Individual Corporate DirectorBoard Member Jan 1, 2009
Laura J Arnow Individual Corporate DirectorBoard Member Mar 1, 2008
Suzanne J Sanicola Individual Corporate DirectorBoard Member Jun 1, 2003
Julie B Schuller Individual Corporate OfficerCeo & President Apr 1, 2015
W-2 Managing Employee Sep 1, 1995
Levi U Sosa Individual Corporate DirectorBoard Member Feb 1, 2007
Jeffrey a Stearns Individual Corporate DirectorBoard Member Sep 1, 2001
Richard J Walters Individual Corporate Director Sep 1, 2001
Wayne F Heidenreich Individual Corporate DirectorBoard Member Nov 1, 2008
Galo I Vargas Individual Corporate DirectorBoard Member Jun 1, 2003
Kathryn Hein Individual Corporate DirectorBoard Member May 1, 2007

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 50

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 50

NPI Registry JSON

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

{
    "created_epoch": "1328832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736294400000",
    "number": "1144593815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 778789",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606778789",
            "telephone_number": "414-672-1353",
            "fax_number": "262-408-5094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 E NORTH ST",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883718",
            "telephone_number": "414-672-1353",
            "fax_number": "262-408-5094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "16TH STREET COMMUNITY HEALTH CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-10",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A",
        "authorized_official_last_name": "STAMPS",
        "authorized_official_first_name": "TANYA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "414-897-5407"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "WI",
            "license": "1507-800",
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100024527",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144593815",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "16th Street Community Health Center Inc.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sixteenth Street Community Health Centers",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sixteenth Street Community Health Centers",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sixteenth Street Community Health Center Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Sixteenth Street Community Health Centers Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.