Sac Health System
Organization Active NPI Federally Qualified Health Center (FQHC) · Murrieta, CA
NPI 1164045522 · NPPES record last updated Apr 21, 2025
Key facts
- NPI
- 1164045522
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- SAC HEALTH SYSTEM
- Practice address
- 28078 Baxter Rd Ste 540
Murrieta, CA 92563-1405 - Phone
- (909) 382-7100
- Fax
- (909) 382-7101
- NPI assigned
- May 20, 2020
- Organization subpart
- No
Authorized official
- Name
- Tasha Amick
- Title
- Director of Billing
- Phone
- (909) 382-7100
Owners & managing parties with NPI records 2
-
Richard H. Hart, M.D.
-
Jason Lee Lohr, M.D.
Other NPIs on the same Medicare enrollment 9
Other NPIs with the same Medicare PAC ID 12
Practitioners 243
-
Sana Afroz, MD
-
Jasjot K. Bhullar, M.D.
-
Nancy Forrest Hardy, M.D.
-
Cesia Garrido, MD
-
William Guthrie, MD
-
Jason Lee Lohr, M.D.
-
Megan Pelter, M.D
-
Joseph Scott Russo, D.O.
-
Cristina Valdivia, FNP MSN
-
Amir Abdi Pour, MD
-
Dmitry Abramov, M.D.
-
Wendy Celines Alberty, MSN, APRN, FNP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CA
Federally qualified health center certification: CCN 921914
- Legal name
- SAC HEALTH SYSTEM
- Doing business as
- SAC MURRIETA
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Apr 26, 2021
- Last certification
- Apr 26, 2021
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Sep 18, 1995 in CA
- Enrollment address
- 28078 Baxter Rd
Ste 540
Murrieta, CA 92563-1405
All disclosed owners & managing parties 12
| Name | Role | Since | Share |
|---|---|---|---|
| Angela Teresi |
W-2 Managing Employee | Jun 29, 2015 | |
| Jason Lohr |
Corporate Officer | Jun 29, 2018 | |
| Eliane B. Zucco |
Corporate Director | Aug 1, 2016 | |
| Eric Ngo |
Corporate Director | Mar 1, 2010 | |
| Pat Morris |
Corporate Director | Sep 24, 2019 | |
| Raul Castillo |
Corporate Director | Apr 1, 2014 | |
| Richard Henry Hart |
Corporate Director | Jul 1, 2014 | |
| Edith Ann Atkinson |
Corporate Director | Mar 1, 2010 | |
| Rodney Neal |
Corporate Director | Sep 1, 2014 | |
| John B Skelton |
Corporate Officer | Apr 8, 2019 | |
| Matthew J List |
Corporate Director | Oct 22, 2019 | |
| Marilyn Hermann |
Corporate Director | Mar 1, 2010 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040315000608 | CA | Part B Supplier - Clinic/Group Practice | 4385533579 |
Receives reassigned benefits from 461 practitioners 9 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Indio, CA; Murrieta, CA; Rialto, CA; San Bernardino, CA |
| O20210503000489 | CA | Part a Provider - Federally Qualified Health Center (FQHC) | 4385533579 | Practice locations: Murrieta, CA |
National Provider Directory
Locations
28078 Baxter Rd
Ste 540
Murrieta, CA 92563
Phone (909) 381-7100
1455 3rd Ave
Sn Bernrdno, CA 92408
Phone (909) 382-7146
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Clinic/Center | 261QC1500X | |||
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes | ||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X |
Addresses
Primary practice location
28078 Baxter Rd Ste 540
Murrieta, CA 92563-1405
Mailing address
250 S G St
San Bernardino, CA 92410-3320
Phone (909) 382-7100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| EAP70708F | Other | CA | EAPC |
| CMM70708F | Medicaid | CA | |
| ENVOY3000 | Other | CA | ENVOY SITE ID |
Other providers in Murrieta, CA
- S & J Helping Hands
- Ardavan Ariel Saadat
- Laura Saavedra
- Aaliyah Sabree
- Jameeka Sabree
- Sac Health System
- Sac Health System
- Charlotte Sackett
- Sacred Nurture Doula Care
- Nadin Abdulelah Sadiq
All providers in Murrieta, 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 Apr 21, 2025. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.