NPIMap

Organization Active NPI

County of Stanislaus

  • Community/Behavioral Health Agency
  • Modesto, CA
National Provider Identifier
1154524445
Registry record updated Feb 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COUNTY OF STANISLAUS
Practice address
500 N 9TH St Ste B
Modesto, CA 95350-5814
Phone
(209) 525-6225
NPI assigned
Jun 6, 2007
Organization subpart
Yes
Parent organization
COUNTY OF STANISLAUSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 3, 2022

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

Authorized official

Name
Ruben Imperial, MBA
Title
Behavioral Health Director
Phone
(209) 525-6225

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

500 N 9TH St Ste B
Modesto, CA 95350-5814

Mailing address

800 Scenic Dr
Modesto, CA 95350-6131
Phone (209) 525-6225

Other identifiers 2

IdentifierTypeStateIssuer
5083MedicaidCA
50BLMedicaidCA

Other names 1

  • High Risk Health & Senior Access Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031111000935 CA Part B Supplier - Clinic/Group Practice 0648183996 Receives reassigned benefits from 24 practitioners
15 other NPIs on this enrollment
Practice locations: Ceres, CA; Modesto, CA; Turlock, CA
O20041108000570 CA Part B Supplier - Clinic/Group Practice 0648183996 Receives reassigned benefits from 36 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ceres, CA; Modesto, CA; Turlock, CA

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 19

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

View all 19

National Provider Directory

National Provider Directory
Tax ID family
Scenic Medical Group113 organizations share this tax ID, including this one
Part of
Scenic Medical Group

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Stanislaus County Health Services Agency Family & Pediatric Health CenModesto, CA, CCN 051122 Federally qualified health center Operational/Managerial Control Sep 20, 2007
Stanislaus County Health Services Agency McHenry Medical OfficeModesto, CA, CCN 051121 Federally qualified health center Operational/Managerial Control Sep 20, 2007
Stanislaus County Health Services Agency Paradise Medical OfficeModesto, CA, CCN 051117 Federally qualified health center Operational/Managerial Control Sep 20, 2007

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 41

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643846400000",
    "number": "1154524445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SCENIC DR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953506131",
            "telephone_number": "209-525-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N 9TH ST STE B",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953505814",
            "telephone_number": "209-525-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF STANISLAUS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF STANISLAUS",
        "enumeration_date": "2007-06-06",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A",
        "authorized_official_last_name": "IMPERIAL",
        "authorized_official_first_name": "RUBEN",
        "authorized_official_title_or_position": "BEHAVIORAL HEALTH DIRECTOR",
        "authorized_official_telephone_number": "209-525-6225",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5083",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50BL",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "High Risk Health & Senior Access",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "High Risk Health & Senior Access",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.