NPIMap

Organization Active NPI

219 Health Network, Inc.

Doing business as 219 Health Network

  • Federally Qualified Health Center (FQHC)
  • East Chicago, IN
National Provider Identifier
1235928938
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
219 HEALTH NETWORK, INC.
Doing business as
219 Health Network
Practice address
4320 Fir St
Unit 220
East Chicago, IN 46312-3076
Phone
(219) 703-2591
Fax
(219) 703-6772
NPI assigned
May 1, 2025
Last updated
May 1, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Authorized official

Name
William Cortes
Title
Executive Director
Phone
(219) 703-2585

Specialties & licenses 1

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

Addresses

Primary practice location

4320 Fir St
Unit 220
East Chicago, IN 46312-3076

Mailing address

100 W Chicago Ave Ste F
East Chicago, IN 46312-3261
Phone (219) 392-7016

Other names 1

  • 219 Health Network Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250919001554 IN Part A Provider - Federally Qualified Health Center (FQHC) 0547521452 Practice locations: East Chicago, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1235928938. Details of each certification follow.

Federally qualified health center certification: CCN C51105

Legal name
219 HEALTH NETWORK INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 12, 2025
Last certification
Sep 12, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
4320 Fir St
Unit 220
East Chicago, IN 46312-3076

National Provider Directory

National Provider Directory
Tax ID family
219 Health Network Inc39 organizations share this tax ID, including this one

Other organizations with this tax ID 38

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

View all 38

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
Luis Molina Individual Corporate OfficerTreasurer Jul 25, 2018
William Cortes Individual Corporate DirectorExecutive Director Apr 28, 2024
W-2 Managing EmployeeExecutive Director Apr 28, 2024
Gloria Vela Individual Corporate Director Apr 9, 2018
Marjol Rush-Collet Individual Corporate DirectorDirector Apr 9, 2018
Leo Correa Individual Corporate DirectorChairman Jul 25, 2018
Sandra Noe Individual Corporate DirectorDirector Aug 30, 2023
Sava Pavkovich Individual Corporate OfficerSecretary Aug 30, 2023
Milton Reed Individual Corporate DirectorDirector Apr 9, 2018
Sara Jiminez Individual Corporate Director Dec 18, 2018
Martha Gonzalez Individual Corporate DirectorDirector Oct 26, 2022

Practitioners & affiliated clinicians

Practitioners 4

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": "1746057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746057600000",
    "number": "1235928938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W CHICAGO AVE STE F",
            "city": "EAST CHICAGO",
            "state": "IN",
            "postal_code": "463123261",
            "telephone_number": "219-392-7016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 FIR ST",
            "address_2": "UNIT 220",
            "city": "EAST CHICAGO",
            "state": "IN",
            "postal_code": "463123076",
            "telephone_number": "219-703-2591",
            "fax_number": "219-703-6772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "219 HEALTH NETWORK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-01",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A",
        "authorized_official_last_name": "CORTES",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "219-703-2585"
    },
    "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": "219 Health Network",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in East Chicago, IN

Sources for this page

Verify at the official NPI Registry.