NPIMap

Organization Active NPI

Clinica de Salud del Valle de Salinas

  • Federally Qualified Health Center (FQHC)
  • King City, CA
National Provider Identifier
1376684456
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
070000264 Issued in CA
Legal business name
CLINICA DE SALUD DEL VALLE DE SALINAS
Practice address
122 San Antonio Drive
King City, CA 93930-2942
Phone
(831) 385-5945
Fax
(831) 385-0767
NPI assigned
Feb 9, 2007
Last updated
Jun 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Authorized official

Name
Dr. Maximiliano Cuevas, M.D.
Title
Ceo
Phone
(831) 757-8689

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 070000264 CA Primary

Addresses

Primary practice location

122 San Antonio Drive
King City, CA 93930-2942

Mailing address

55 Plaza Cir Ste a
Salinas, CA 93901-2952
Phone (831) 757-8689

Other identifiers 1

IdentifierTypeStateIssuer
FHC70419FMedicaidCA

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070502000668 CA Part A Provider - Federally Qualified Health Center (FQHC) 3678513736 Practice locations: King City, CA
O20081118000667 CA Part B Supplier - Clinic/Group Practice 3678513736 Receives reassigned benefits from 71 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Castroville, CA; Gonzales, CA; Greenfield, CA; King City, CA; Royal Oaks, CA; Salinas, CA; Soledad, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376684456. Details of each certification follow.

Federally qualified health center certification: CCN 051954

Legal name
CLINICA DE SALUD DEL VALLE DE SALINAS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 1, 1995
Last certification
Jul 1, 1995
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 9, 1980 in CA
Enrollment address
122 E San Antonio Dr
King City, CA 93930-2518

Other NPIs with the same Medicare PAC ID 9

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

Other NPIs on the same Medicare enrollment 11

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

National Provider Directory

National Provider Directory

Locations

440 Airport Blvd
Salinas, CA 93905
Phone (831) 757-0434

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Maximiliano Cuevas Individual Corporate DirectorCeo Dec 7, 2006
Michael Victor Individual Corporate OfficerController Jan 14, 2019
Ruben Jimenez Individual W-2 Managing EmployeeBilling Manager Sep 5, 2018
Jesus Lopez Individual Corporate DirectorBoard Member Jan 1, 2015
Maria Villagomez Individual Operational/Managerial ControlClinic Manager Jan 1, 2015
Rogelio Jacinto Individual Corporate DirectorBoard Member Jan 1, 2015
Raymond Gonzalez Individual Corporate DirectorBoard Member Jan 1, 2015
Maria Aguilar Individual Corporate DirectorBoard Member Jan 1, 2015
Genaro Carlos Individual Corporate DirectorBoard Member Jan 1, 2015
Victoria Coley Individual Corporate Director Feb 7, 2019
Ali Chavez Individual Corporate DirectorBoard Member Jan 1, 2015
Elizabeth Reyes Individual Corporate DirectorBoard Member Apr 24, 2007
Aurelio Gonzalez Individual Corporate Director Oct 7, 2010
Silvana Fiege Individual W-2 Managing EmployeeBilling Supervisor Jan 12, 2009
Josefina Rodriguez Individual Corporate DirectorBoard Member Jan 1, 2015
Criselia Serrano Individual Corporate DirectorBoard Member Jan 1, 2015

Owners & managing parties with NPI records 1

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
CSVS - Plaza CircleSalinas, CA, CCN A01118 Federally qualified health center Operational/Managerial Control Aug 1, 2022

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 3

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": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717632000000",
    "number": "1376684456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 PLAZA CIR STE A",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939012952",
            "telephone_number": "831-757-8689",
            "fax_number": "831-757-3721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 SAN ANTONIO DRIVE",
            "city": "KING CITY",
            "state": "CA",
            "postal_code": "939302942",
            "telephone_number": "831-385-5945",
            "fax_number": "831-385-0767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA DE SALUD DEL VALLE DE SALINAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A",
        "authorized_official_last_name": "CUEVAS",
        "authorized_official_first_name": "MAXIMILIANO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "831-757-8689",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "070000264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC70419F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in King City, CA

Sources for this page

Verify at the official NPI Registry.