NPIMap

Organization Active NPI

Apla Health & Wellness

Doing business as APLA Health - 3741 S. La Brea Ave.

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
National Provider Identifier
1225793631
Registry record updated Nov 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
APLA HEALTH & WELLNESS
Doing business as
APLA Health - 3741 S. La Brea Ave.
Practice address
3741 S la Brea Ave
Los Angeles, CA 90016-5309
Phone
(323) 329-9010
NPI assigned
Nov 2, 2021
Last updated
Nov 2, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
APLA HEALTH & WELLNESSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 2, 2021

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

Authorized official

Name
Robyn Goldman
Title
Cfo
Phone
(213) 201-1546

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

3741 S la Brea Ave
Los Angeles, CA 90016-5309

Mailing address

611 S Kingsley Dr
Los Angeles, CA 90005-2319
Phone (213) 201-1546

Other names 1

  • APLA Health - 3741 S. La Brea Ave. Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160420000343 CA Part B Supplier - Clinic/Group Practice 4385875236 Receives reassigned benefits from 3 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Los Angeles, CA; Long Beach, CA; West Hollywood, CA
O20220419000799 CA Part A Provider - Federally Qualified Health Center (FQHC) 4385875236 Practice locations: Los Angeles, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1225793631. Details of each certification follow.

Federally qualified health center certification: CCN A01073

Legal name
APLA HEALTH & WELLNESS
Doing business as
APLA HEALTH - 3741 S LA BREA
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 28, 2022
Last certification
Feb 28, 2022
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Sep 16, 2004 in CA
Enrollment address
3741 S la Brea Ave
Los Angeles, CA 90016-5309

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory
Tax ID family
Apla Health Wellness12 organizations share this tax ID, including this one
Part of
Apla Health Wellness

Other organizations with this tax ID 11

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

Ownership & related parties

All disclosed owners & managing parties 23

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

NameRoleSinceShare
Peter Perkowski Individual Corporate DirectorBoard - Chair Oct 22, 2013
Lee Klosinski Individual Corporate DirectorBoard - Vice Chair Oct 22, 2013
Hector Perez Individual Corporate DirectorBoard Member Jun 24, 2020
Jessie McGrath Individual Corporate DirectorBoard - Secretary Jan 27, 2017
Duncan Joseph Moore Individual Corporate DirectorBoard Member Oct 26, 2016
Cody Sisco Individual Corporate DirectorBoard Member Jun 26, 2019
Christopher Tang Individual Corporate DirectorBoard Member Jun 30, 2021
Ronald J Sylvester Individual Corporate DirectorBoard Member Jan 27, 2017
John Squatritto Individual Corporate DirectorBoard Member Jun 26, 2019
Craig E Thompson Individual Corporate OfficerChief Executive Officer Jan 6, 1997
Alan R Walden Individual Corporate DirectorBoard - Treasurer Jan 27, 2017
Jay E Gladstein Individual W-2 Managing EmployeeChief Medical Officer Dec 1, 2017
Chad Franks Individual Corporate DirectorBoard Member Jun 26, 2019
Robyn L Goldman Individual Corporate OfficerChief Financial Officer Aug 9, 2010
James Patton Individual Corporate DirectorBoard Member Oct 28, 2015
Maricela de Rivera Individual Corporate DirectorBoard Member Jun 30, 2021
Mark Kadzielski Individual Corporate DirectorBoard Member Jun 26, 2019
Lindsey Morrison Individual Corporate DirectorBoard Member Jun 30, 2021
Anthony Henderson Individual Corporate DirectorBoard Member Jan 27, 2017
John Sealy Individual Corporate DirectorBoard Member Jun 26, 2019
Natalia Ramos Individual Corporate DirectorBoard Member Jun 26, 2019
M'Alyssa Mecenas Individual Corporate DirectorBoard Member Jun 24, 2020
Paula M Cannon Individual Corporate DirectorBoard Member Oct 25, 2017

Owners & managing parties with NPI records 2

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Apla Health & Wellness - David Geffen CenterLos Angeles, CA, CCN 751061 Federally qualified health center Other (100%) Oct 9, 2012
Apla Health - Olympic #310Los Angeles, CA, CCN 921032 Federally qualified health center Other Oct 22, 2013

Owned or controlled facilities with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 6

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": "1635811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635811200000",
    "number": "1225793631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 S KINGSLEY DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900052319",
            "telephone_number": "213-201-1546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3741 S LA BREA AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900165309",
            "telephone_number": "323-329-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APLA HEALTH & WELLNESS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "APLA HEALTH & WELLNESS",
        "enumeration_date": "2021-11-02",
        "last_updated": "2021-11-02",
        "certification_date": "2021-10-21",
        "status": "A",
        "authorized_official_last_name": "GOLDMAN",
        "authorized_official_first_name": "ROBYN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "213-201-1546"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "APLA Health - 3741 S. La Brea Ave.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.