NPIMap

Organization Active NPI

Esperanza Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
National Provider Identifier
1306933346
Registry record updated Oct 17, 2012
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
2940 N. 5TH Street
Philadelphia, PA 19133-2801
Phone
(215) 221-6633
Fax
(215) 224-5644
NPI assigned
Oct 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2012

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

Authorized official

Name
Dr. Susan M Post, D.MIN., MBA
Title
Executive Director
Phone
(215) 302-3600

Specialties & licenses 1

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

Addresses

Primary practice location

2940 N. 5TH Street
Philadelphia, PA 19133-2801

Mailing address

4417 N. 6TH St.
Philadelphia, PA 19140-2319
Phone (215) 302-3600

Other identifiers 1

IdentifierTypeStateIssuer
107734560007MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

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
This NPI is an additional NPI on the enrollment
Practice locations: Philadelphia, PA
O20060707000089 PA Part A Provider - Federally Qualified Health Center (FQHC) 6103815071 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Philadelphia, PA

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

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

Ownership & related parties

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
Stephanie Stanford Individual Corporate Director Apr 24, 2014
David Crosscombe Individual Corporate Director Apr 1, 2000
Shana Kline Individual Corporate DirectorDirector/President Dec 15, 2016
Alan Popoli Individual Corporate OfficerBoard Treasurer Aug 26, 2019
Taehoo Lee Individual Corporate Director 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
Esperanza Health Center, Inc. Organization, Philadelphia, PA Non-profit Operational/Managerial Control Sep 1, 2006 100%
Juan Perez Individual Operational/Managerial ControlDirector of Operations Nov 18, 2013
Timothy Leaman Individual Operational/Managerial ControlChief Medical Officer Nov 28, 2022

Owners & managing parties with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 37

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

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350432000000",
    "number": "1306933346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4417 N. 6TH ST.",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191402319",
            "telephone_number": "215-302-3600",
            "fax_number": "215-805-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 N. 5TH STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191332801",
            "telephone_number": "215-221-6633",
            "fax_number": "215-224-5644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESPERANZA HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2012-10-17",
        "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": "215-302-3600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.MIN., MBA"
    },
    "taxonomies": [
        {
            "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": "107734560007",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.