NPIMap

Organization Active NPI

Esperanza Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
National Provider Identifier
1255726659
Registry record updated Apr 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ESPERANZA HEALTH CENTER, INC.
Practice address
4417 N 6TH St
Esperanza Health Cen
Philadelphia, PA 19140-2319
Phone
(215) 302-3150
NPI assigned
Apr 2, 2015
Last updated
Apr 2, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2015

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

Authorized official

Name
Susan M Post, D.MIN, MBA
Title
Executive Director
Phone
(215) 302-3150

Specialties & licenses 1

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

Addresses

Primary practice location

4417 N 6TH St
Esperanza Health Cen
Philadelphia, PA 19140-2319

Mailing address

4417 N 6TH St
Esperanza Health Cen
Philadelphia, PA 19140-2319
Phone (215) 302-3150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20040507000367 PA Part B Supplier - Clinic/Group Practice 6103815071 Receives reassigned benefits from 53 practitioners
3 other NPIs on this enrollment
Practice locations: Philadelphia, PA
O20060707000089 PA Part A Provider - Federally Qualified Health Center (FQHC) 6103815071 2 other NPIs on this enrollment
Practice locations: Philadelphia, PA
O20060707000095 PA Part A Provider - Federally Qualified Health Center (FQHC) 6103815071 1 other NPI on this enrollment
Practice locations: Philadelphia, PA
O20111214000203 PA Part A Provider - Federally Qualified Health Center (FQHC) 6103815071 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Philadelphia, PA

NPI to CCN mapping 3

The Medicare certification numbers (CCNs) connected to NPI 1255726659. Details of each certification follow.

Federally qualified health center certification: CCN 391958

Legal name
ESPERANZA HEALTH CENTER, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 25, 2006
Last certification
Jul 25, 2006
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 24, 1987 in PA
Enrollment address
2940 N 5TH St
Philadelphia, PA 19133-2801

Federally qualified health center certification: CCN 391959

Legal name
ESPERANZA HEALTH CENTER, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 25, 2006
Last certification
Jul 25, 2006
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 24, 1987 in PA
Enrollment address
861 E Allegheny Ave
Philadelphia, PA 19134-2401

Federally qualified health center certification: CCN 391019

Legal name
ESPERANZA HEALTH CENTER, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 14, 2011
Last certification
Dec 14, 2011
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1990 in PA
Enrollment address
4417 N 6TH Street
Philadelphia, PA 19140-2319

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 3

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

National Provider Directory

National Provider Directory

Locations

1331 E Wyoming Ave
Ofc
Philadelphia, PA 19124
Phone (215) 238-2265

2940 N 5th St
Philadelphia, PA 19133
Phone (215) 221-6633

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Stephanie Stanford Individual Corporate Director Apr 24, 2014
Corporate DirectorBoard Secretary Apr 24, 2014
David Crosscombe Individual Corporate Director Apr 1, 2000
Shana Kline Individual Corporate DirectorDirector/President Dec 15, 2016
Corporate DirectorDirector Dec 15, 2016
Alan Popoli Individual Corporate OfficerBoard Treasurer Aug 26, 2019
Taehoo Lee Individual Corporate Director Jul 25, 2014
Corporate DirectorDirector Jul 25, 2014
Ruth Elliot Individual Corporate OfficerBoard Secretary Mar 4, 2022
Eapen Johnson Individual Corporate DirectorChief Administrative Officer Jul 1, 2024
Susan Post Individual Corporate Director Feb 1, 2005
Corporate OfficerExecutive Director Feb 1, 2005
W-2 Managing Employee Feb 1, 2005
Operational/Managerial ControlExecutive Director Feb 1, 2005
Corporate DirectorCeo - Executive Director Nov 1, 2011
W-2 Managing EmployeeCeo - Executive Director Nov 1, 2011
Esperanza Health Center, Inc. Organization, Philadelphia, PA Non-profit Operational/Managerial Control Sep 1, 2006 100%
Operational/Managerial Control Dec 1, 2011 100%
Juan Perez Individual Operational/Managerial ControlDirector of Operations Nov 18, 2013
W-2 Managing EmployeeOperations Director Nov 18, 2013
Timothy Leaman Individual Operational/Managerial ControlChief Medical Officer Nov 28, 2022
Corporate OfficerChief Medical Officer Nov 28, 2022
Jacinto Gomez Individual Corporate DirectorDirector Oct 22, 2009
Lara Maria Lahr Individual Corporate DirectorDirector Feb 22, 2018
Erik Davis Individual W-2 Managing EmployeeFinance Director Sep 15, 2011
Bryan R Hollinger Individual W-2 Managing EmployeeMedical Director Oct 1, 1994
Roberto Vargas Individual Corporate DirectorBoard Vice President Apr 26, 2012
Nancy Rivera Individual Corporate DirectorDirector Feb 25, 2016
Glenna J Deem Individual W-2 Managing EmployeeCredentialing Manager Jun 25, 2015

Owners & managing parties with NPI records 4

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Esperanza Health Center, Inc.Philadelphia, PA, CCN 391019 Federally qualified health center Operational/Managerial Control (100%) Dec 1, 2011

Owned or controlled facilities with NPI records 3

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

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 58

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 58

NPI Registry JSON

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

{
    "created_epoch": "1427932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427932800000",
    "number": "1255726659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4417 N 6TH ST",
            "address_2": "ESPERANZA HEALTH CEN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191402319",
            "telephone_number": "215-302-3150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4417 N 6TH ST",
            "address_2": "ESPERANZA HEALTH CEN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191402319",
            "telephone_number": "215-302-3150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESPERANZA HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-02",
        "last_updated": "2015-04-02",
        "status": "A",
        "authorized_official_last_name": "POST",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "215-302-3150",
        "authorized_official_credential": "D.MIN, MBA"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.