NPIMap

Organization Active NPI

Community Health Centers of Pinellas Inc.

Doing business as Evara Health

  • Federally Qualified Health Center (FQHC)
  • Largo, FL
National Provider Identifier
1255319976
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH CENTERS OF PINELLAS INC.
Doing business as
Evara Health
Practice address
12420 130TH Ave
Largo, FL 33774-1950
Phone
(727) 587-7729
Fax
(727) 587-7739
NPI assigned
Jan 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Authorized official

Name
Edward Kucher
Title
Chief Regulatory Officer
Phone
(727) 824-8100

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

12420 130TH Ave
Largo, FL 33774-1950

Mailing address

14100 58TH St N Ste 100
Clearwater, FL 33760-9900
Phone (727) 824-8126

Other identifiers 2

IdentifierTypeStateIssuer
029565512MedicaidFL
029565513MedicaidFL

Other names 1

  • Evara Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040131000031 FL Part B Supplier - Clinic/Group Practice 8527961028 Receives reassigned benefits from 135 practitioners
18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Largo, FL; Tarpon Springs, FL; St Petersburg, FL; Saint Petersburg, FL; Pinellas Park, FL; Dunedin, FL; Clearwater, FL
O20060224000235 FL Part A Provider - Federally Qualified Health Center (FQHC) 8527961028 1 other NPI on this enrollment
Practice locations: Largo, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255319976. Details of each certification follow.

Federally qualified health center certification: CCN 101984

Legal name
COMMUNITY HEALTH CENTER OF PINELLAS INC
Doing business as
EVARA HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 8, 2006
Last certification
Mar 8, 2006
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Nov 14, 1980 in FL
Enrollment address
12420 130TH Ave
Largo, FL 33774-1919

Other NPIs with the same Medicare PAC ID 19

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

View all 19

Other NPIs on the same Medicare enrollment 18

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

View all 18

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1097814Evara Health12420 130TH Ave N, Largo, FL 33774Provider-performed microscopyJul 1, 2027

National Provider Directory

National Provider Directory
Tax ID family
Community Health Center24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

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

View all 23

Locations

12420 130th Ave N
Largo, FL 33774
Phone (727) 587-7729

1344 22nd St S
St Petersburg, FL 33712
Phone (727) 821-6701

247 S Huey Ave
Tarpon Springs, FL 34689
Phone (727) 944-3828

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Elodie Dorso Individual Corporate OfficerCeo Feb 2, 2018 100%
W-2 Managing EmployeeCeo Aug 1, 2014 100%
Operational/Managerial ControlCeo Aug 1, 2014 100%
Edward Kucher Individual Corporate OfficerCoo Feb 27, 2017
W-2 Managing EmployeeCoo Feb 27, 2017
Operational/Managerial ControlCoo Mar 16, 2018

Practitioners & affiliated clinicians

Practitioners 22

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 22

NPI Registry JSON

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759968000000",
    "number": "1255319976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14100 58TH ST N STE 100",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337609900",
            "telephone_number": "727-824-8126",
            "fax_number": "727-824-8166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12420 130TH AVE",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337741950",
            "telephone_number": "727-587-7729",
            "fax_number": "727-587-7739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTERS OF PINELLAS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-03",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A",
        "authorized_official_last_name": "KUCHER",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "CHIEF REGULATORY OFFICER",
        "authorized_official_telephone_number": "727-824-8100"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029565512",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029565513",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evara Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Largo, FL

Sources for this page

Verify at the official NPI Registry.