Organization Active NPI

Dap Health, Inc.

Doing business as DAP Health-Centro Medico El Cajon

  • Federally Qualified Health Center (FQHC)
  • El Cajon, CA
National Provider Identifier
1154480069
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
DAP HEALTH, INC.
Doing business as
DAP Health-Centro Medico El Cajon
Practice address
133 W Main St
El Cajon, CA 92020-3315
Phone
(619) 401-0404
NPI assigned
Dec 6, 2006
Last updated
Mar 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Authorized official

Name
Judy Stith
Title
Chief Administrative Officer
Phone
(760) 323-2118

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X CA
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

133 W Main St
El Cajon, CA 92020-3315

Mailing address

1695 N. Sunrise Way
Palm Springs, CA 92262
Phone (760) 323-2118

Other names 1

  • DAP Health-Centro Medico El Cajon Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100608000193 CA Part B Supplier - Clinic/Group Practice 6002989522 Receives reassigned benefits from 103 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Thermal, CA; San Jacinto, CA; Cathedral City, CA; Palm Springs, CA; Escondido, CA; El Cajon, CA; Desert Hot Springs, CA; Coachella, CA…
O20240401002689 CA Part A Provider - Federally Qualified Health Center (FQHC) 6002989522 Practice locations: El Cajon, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1154480069. Details of each certification follow.

Federally qualified health center certification: CCN 051095

Legal name
DAP HEALTH INC
Doing business as
DAP HEALTH-CENTRO MEDICO EL CAJON
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 14, 2007
Last certification
Jun 14, 2007
Ownership / control type
For profit – corporation
Most recent change of ownership
Jul 1, 2023 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Aug 22, 1984 in CA
Enrollment address
133 W Main St
El Cajon, CA 92020-3315

Other NPIs with the same Medicare PAC ID 14

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

View all 14

Other NPIs on the same Medicare enrollment 14

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

View all 14

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
05D0915458Dap Health - Centro Medico El Cajon133 W Main St Ste 100, El Cajon, CA 92020Certificate of waiverJun 14, 2027

National Provider Directory

National Provider Directory

Locations

1121 E Washington Ave
Escondido, CA 92025
Phone (760) 871-0606

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
David Brinkman Individual Corporate OfficerCeo Aug 1, 2023 100%
Patrick Jordan Individual Corporate DirectorChair Aug 1, 2023
Frederick Drewette Individual Corporate DirectorTreasurer Aug 1, 2023
Gladis Adriana Perez Individual W-2 Managing EmployeeHealth Plan Coordinator Aug 1, 2023
Veronica Willimas Individual Corporate DirectorMember Feb 27, 2024
Judy Stith Individual Corporate OfficerChief Administrative Officer Aug 1, 2023
Athalie Lapamuk Individual Corporate DirectorMember Aug 1, 2023
Scot Karp Individual Corporate DirectorMember Jun 1, 2024
Mark Charles Adams Individual Corporate DirectorMember Jun 1, 2024
Kevin Bass Individual Corporate DirectorVice Co-Chair Aug 1, 2023
Carolyn Caldwell Individual Corporate DirectorMember Aug 1, 2023
Bruce Finch Individual Corporate DirectorMember Aug 1, 2023
Karyl Ketchum Individual Corporate DirectorMember Aug 1, 2023
Frank Figueroa Individual Corporate DirectorMember Aug 1, 2023
Eve Fromberg Individual Corporate DirectorVice Co-Chair Aug 1, 2023
Mark Hamilton Individual Corporate DirectorSecretary Aug 1, 2023

Change-of-ownership history 2

DateEventCounterparty
Jul 31, 2023 Change of OwnershipThis provider was the buyer Centro Medico, El CajonCCN 051095, CA, NPI 1154480069
Jul 31, 2023 Change of OwnershipThis provider was the seller Dap Health-Centro Medico El CajonCCN 051095, CA, NPI 1154480069

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709769600000",
    "number": "1154480069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1695 N. SUNRISE WAY",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "92262",
            "telephone_number": "760-323-2118",
            "fax_number": "619-401-0522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 W MAIN ST",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920203315",
            "telephone_number": "619-401-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAP HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A",
        "authorized_official_last_name": "STITH",
        "authorized_official_first_name": "JUDY",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "760-323-2118"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DAP Health-Centro Medico El Cajon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in El Cajon, CA

Sources for this page

Verify at the official NPI Registry.