NPIMap

Organization Active NPI

Erick Madrigal, MD, Mba Inc.

Doing business as Clinica Agua Viva-Woodlake

  • Family Medicine Physician
  • Woodlake, CA
National Provider Identifier
1174237135
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ERICK MADRIGAL, MD, MBA INC.
Doing business as
Clinica Agua Viva-Woodlake
Practice address
101 N Palm St
Woodlake, CA 93286-1422
Phone
(559) 564-1100
Fax
(559) 789-9828
NPI assigned
Jan 12, 2023
Last updated
Apr 21, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
ERICK MADRIGAL, MD, MBA INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Authorized official

Name
Brandy Leyva
Title
Associate Director
Phone
(559) 719-8108

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU
Family Medicine Physician 207Q00000X NU Primary
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

101 N Palm St
Woodlake, CA 93286-1422

Mailing address

222 W Henderson Ave
Porterville, CA 93257-1731
Phone (559) 784-5483

Other names 1

  • Clinica Agua Viva-Woodlake Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://6501.portal.athenahealth.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230324000458 CA Part A Provider - Rural Health Clinic 9436395324 Practice locations: Woodlake, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1174237135. Details of each certification follow.

Rural health clinic certification: CCN 058989

Legal name
ERICK MADRIGAL MD MBA INC
Doing business as
CLINICA AGUA VIVA - WOODLAKE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 28, 2016
Last certification
Apr 10, 2025
Ownership / control type
1C
Most recent change of ownership
Dec 28, 2022 (1 total)
Organization structure
CorporationProprietary
Incorporated
Oct 15, 2011 in CA
Enrollment address
101 N Palm St
Woodlake, CA 93286-1422

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Erick Madrigal MD Mba Inc4 organizations share this tax ID, including this one
Part of
Erick Madrigal MD Mba Inc

Other organizations with this tax ID 3

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

Locations

101 N Palm St
Woodlake, CA 93286
Phone (559) 564-0100

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6501/brand/1/csg/1/fhir/r4

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
Erick Madrigal Individual 5% Or Greater Direct Ownership InterestOwner Dec 28, 2022 100%
Corporate OfficerChief Executive Officer Dec 28, 2022
Corporate DirectorPresident Dec 28, 2022
W-2 Managing EmployeeChief Executive Officer Dec 28, 2022

Owners & managing parties with NPI records 1

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

  • Erick Madrigal, M.D.
    • Family Medicine Physician
    • Porterville, CA
    • NPI 1437478856

    5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, W-2 Managing Employee

    CMS ownership

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Clinica Agua VivaLindsay, CA, CCN 558907 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Sep 30, 2011

Owned or controlled facilities with NPI records 1

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

Change-of-ownership history 1

DateEventCounterparty
Dec 28, 2022 Change of OwnershipThis provider was the buyer Clinica El Lago IncCCN 058989, CA, NPI 1386077857

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Practitioners 1

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": "1673481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776729600000",
    "number": "1174237135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 W HENDERSON AVE",
            "city": "PORTERVILLE",
            "state": "CA",
            "postal_code": "932571731",
            "telephone_number": "559-784-5483",
            "fax_number": "559-789-9828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N PALM ST",
            "city": "WOODLAKE",
            "state": "CA",
            "postal_code": "932861422",
            "telephone_number": "559-564-1100",
            "fax_number": "559-789-9828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERICK MADRIGAL, MD, MBA INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ERICK MADRIGAL, MD, MBA INC.",
        "enumeration_date": "2023-01-12",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A",
        "authorized_official_last_name": "LEYVA",
        "authorized_official_first_name": "BRANDY",
        "authorized_official_title_or_position": "ASSOCIATE DIRECTOR",
        "authorized_official_telephone_number": "559-719-8108"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://6501.portal.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "101 N Palm St",
            "city": "Woodlake",
            "state": "CA",
            "country_code": "US",
            "postal_code": "932861422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Clinica Agua Viva-Woodlake",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clinica Agua Viva-Woodlake",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodlake, CA

Sources for this page

Verify at the official NPI Registry.