NPIMap

Organization Active NPI

Open Cities Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Saint Paul, MN
National Provider Identifier
1225101405
Registry record updated Jan 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
OPEN CITIES HEALTH CENTER, INC.
Practice address
409 N Dunlap Street
St. Paul, MN 55104-4201
Phone
(651) 290-9200
Fax
(651) 290-9210
NPI assigned
Nov 16, 2006
Last updated
Jan 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2020

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

Authorized official

Name
Frances Green
Title
HR
Phone
(651) 290-2111

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 3432431 MN
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

409 N Dunlap Street
St. Paul, MN 55104-4201

Mailing address

409 N Dunlap Street
St. Paul, MN 55104-4201
Phone (651) 290-9200

Other identifiers 1

IdentifierTypeStateIssuer
666253600MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20030716000028 MN Part A Provider - Federally Qualified Health Center (FQHC) 5799696621 Practice locations: Saint Paul, MN
O20031110000648 MN Part B Supplier - Clinic/Group Practice 5799696621 Receives reassigned benefits from 24 practitioners
2 other NPIs on this enrollment
Practice locations: Saint Paul, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1225101405. Details of each certification follow.

Federally qualified health center certification: CCN 241807

Legal name
OPEN CITIES HEALTH CENTER INC
Doing business as
OPEN CITIES HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
For profit – partnership
Organization structure
OtherNon-profit
Incorporated
in MN
Enrollment address
409 Dunlap St N
Saint Paul, MN 55104-4201

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IDHIBD

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Jamal Lewis Individual Corporate DirectorVice Chair May 1, 2018
Gabriela Vazquez-Benitez Individual Corporate DirectorPi Committee Chair Nomination Jul 1, 2018
Kee Vang Individual Corporate DirectorBoard Member Nov 1, 2018
Todd Hurley Individual Corporate DirectorFinance Chair Jun 1, 2020
Thuong Pham Individual Corporate DirectorBoard Member Jan 1, 2021
Kaade Wallace Individual Corporate DirectorBoard Member Jul 1, 2017 100%
Nicole Hentges Individual W-2 Managing EmployeeHR Generalist Aug 1, 2020
Ana Diaz Individual Corporate DirectorBoard Member Aug 1, 2016 100%
Sabrina Salazar Individual Corporate OfficerDirector of Revenue Cycle Oct 14, 2024
Corporate DirectorDirector of Revenue Cycle Oct 14, 2024
W-2 Managing EmployeeDirector of Revenue Cycle Oct 14, 2024
Keillen Curtis Individual Corporate DirectorBoard Member Nov 1, 2010 100%

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578614400000",
    "number": "1225101405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 N DUNLAP STREET",
            "city": "ST. PAUL",
            "state": "MN",
            "postal_code": "551044201",
            "telephone_number": "651-290-9200",
            "fax_number": "651-290-9210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 N DUNLAP STREET",
            "city": "ST. PAUL",
            "state": "MN",
            "postal_code": "551044201",
            "telephone_number": "651-290-9200",
            "fax_number": "651-290-9210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN CITIES HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "FRANCES",
        "authorized_official_title_or_position": "HR",
        "authorized_official_telephone_number": "651-290-2111"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MN",
            "license": "3432431",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "666253600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.