NPIMap

Organization Active NPI

County of Santa Cruz

  • Federally Qualified Health Center (FQHC)
  • Santa Cruz, CA
National Provider Identifier
1285033514
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COUNTY OF SANTA CRUZ
Practice address
115A Coral St
Santa Cruz, CA 95060-2131
Phone
(831) 454-2080
Fax
(831) 454-3424
NPI assigned
Aug 22, 2014
Organization subpart
Yes
Parent organization
COUNTY OF SANTA CRUZAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Authorized official

Name
Amy Peeler
Title
Chief of Clinic Services
Phone
(831) 454-4764

Specialties & licenses 1

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

Addresses

Primary practice location

115A Coral St
Santa Cruz, CA 95060-2131

Mailing address

1080 Emeline Ave
Santa Cruz, CA 95060-1966
Phone (831) 454-4764

Other names 1

  • Santa Cruz County Health Services Agency Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031201000370 CA Part B Supplier - Clinic/Group Practice 7618872912 Receives reassigned benefits from 47 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Santa Cruz, CA
O20031201000402 CA Part B Supplier - Clinic/Group Practice 7618872912 Receives reassigned benefits from 56 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Santa Cruz, CA; Watsonville, CA

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
Part of
Puentes Al Sur

Locations

1080 Emeline Ave
Bldg D
Santa Cruz, CA 95060
Phone (831) 454-4000

Practitioners & affiliated clinicians

Practitioners 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1408665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709510400000",
    "number": "1285033514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 EMELINE AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950601966",
            "telephone_number": "831-454-4764",
            "fax_number": "831-454-4893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115A CORAL ST",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950602131",
            "telephone_number": "831-454-2080",
            "fax_number": "831-454-3424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF SANTA CRUZ",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF SANTA CRUZ",
        "enumeration_date": "2014-08-22",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A",
        "authorized_official_last_name": "PEELER",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "CHIEF OF CLINIC SERVICES",
        "authorized_official_telephone_number": "831-454-4764"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Santa Cruz County Health Services Agency",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Santa Cruz County Health Services Agency",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Santa Cruz, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.