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Sac Health System

Organization Active NPI Federally Qualified Health Center (FQHC) · Indio, CA

NPI 1235784166 · NPPES record last updated Apr 21, 2025

Key facts

NPI
1235784166
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
SAC HEALTH SYSTEM
Practice address
47470 Van Buren St
Indio, CA 92201-7139
Phone
(909) 382-7100
NPI assigned
Aug 7, 2019
Organization subpart
No

Authorized official

Name
Tasha Amick
Title
Director of Billing
Phone
(909) 382-7100

Owners & managing parties with NPI records 2

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

Other NPIs on the same Medicare enrollment 9

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

Other NPIs with the same Medicare PAC ID 12

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

Corporate family (same tax ID) 17

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

Practitioners 238

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

View all 238

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in CA

Federally qualified health center certification: CCN 921954

Legal name
SAC HEALTH SYSTEM
Doing business as
SACHS CVRM
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 1, 2021
Last certification
Apr 1, 2021
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Sep 18, 1995 in CA
Enrollment address
47470 Van Buren St
Indio, CA 92201-7139

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Angela Teresi
Individual 		W-2 Managing Employee Jun 29, 2015
Jason Lohr
Individual 		Corporate Officer
Ceo		 Jun 29, 2018
Eric Ngo
Individual 		Corporate Director Mar 1, 2010
Pat Morris
Individual 		Corporate Director Sep 24, 2019
Raul Castillo
Individual 		Corporate Director Apr 1, 2014
Richard Henry Hart
Individual 		Corporate Director Jul 1, 2014
Edith Ann Atkinson
Individual 		Corporate Director Mar 1, 2010
Rodney Neal
Individual 		Corporate Director Sep 1, 2014
John B Skelton
Individual 		Corporate Officer Apr 8, 2019
Matthew J List
Individual 		Corporate Director Oct 22, 2019
Marilyn Hermann
Individual 		Corporate Director Mar 1, 2010

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
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
O20210414002698 CA Part a Provider - Federally Qualified Health Center (FQHC) 4385533579 Practice locations: Indio, CA

National Provider Directory

Tax ID family
Sac Health System Norto (18 organizations share this tax ID)

Locations

47470 Van Buren St
Indio, CA 92201
Phone (760) 342-0042

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

47470 Van Buren St
Indio, CA 92201-7139

Mailing address

250 S G St
San Bernardino, CA 92410-3320
Phone (909) 382-7100

Other identifiers

IdentifierTypeStateIssuer
ENVOY3000OtherCAENVOY SITE ID
EAP70708FOtherCAEAPC
CMM70708FMedicaidCA

Other names

  • SAC INDIO CVRM Doing business as

Other providers in Indio, CA

All providers in Indio, CA · Federally Qualified Health Center (FQHC) in California

Sources for this page

Verify at the official NPI Registry.