NPIMap

Organization Active NPI

Spanish American Civic Association for Equality, Inc

Doing business as Nuestra Clinica

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lancaster, PA
National Provider Identifier
1164502563
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
362450 Issued in PA
Legal business name
SPANISH AMERICAN CIVIC ASSOCIATION FOR EQUALITY, INC
Doing business as
Nuestra Clinica
Practice address
545 Pershing Ave
Lancaster, PA 17602-4369
Phone
(717) 293-4150
Fax
(717) 399-4289
NPI assigned
Oct 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Carlos E. Graupera
Title
President
Phone
(717) 509-3712

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 362450 PA Primary

Addresses

Primary practice location

545 Pershing Ave
Lancaster, PA 17602-4369

Mailing address

545 Pershing Ave
Lancaster, PA 17602-4369
Phone (717) 293-4150

Other identifiers 1

IdentifierTypeStateIssuer
1007776330015MedicaidPA

Other names 1

  • Nuestra Clinica Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050420001075 PA Part B Supplier - Clinic/Group Practice 9436197464 Receives reassigned benefits from 3 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lancaster, PA

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
Nuestra Clinica6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Practitioners & affiliated clinicians

Practitioners 3

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

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": "1598054400000",
    "number": "1164502563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 PERSHING AVE",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176024369",
            "telephone_number": "717-293-4150",
            "fax_number": "717-399-4289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 PERSHING AVE",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176024369",
            "telephone_number": "717-293-4150",
            "fax_number": "717-399-4289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPANISH AMERICAN CIVIC ASSOCIATION FOR EQUALITY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRAUPERA",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "717-509-3712",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "PA",
            "license": "362450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007776330015",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nuestra Clinica",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lancaster, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.