NPIMap

Organization Active NPI

Circle Health Services

  • Federally Qualified Health Center (FQHC)
  • Parma, OH
National Provider Identifier
1417464504
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CIRCLE HEALTH SERVICES
Practice address
5955 Ridge Rd
Parma, OH 44129-3936
Phone
(440) 888-0300
NPI assigned
Jan 10, 2018
Last updated
May 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Authorized official

Name
Christine Gambatese, CPA
Title
Cfo
Phone
(440) 667-9805

Specialties & licenses 1

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

Addresses

Primary practice location

5955 Ridge Rd
Parma, OH 44129-3936

Mailing address

5955 Ridge Rd
Parma, OH 44129-3936
Phone (440) 888-0300

Other identifiers 1

IdentifierTypeStateIssuer
0291120MedicaidOH

Other names 1

  • The Free Medical Clinic of Greater Cleveland Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180627003142 OH Part A Provider - Federally Qualified Health Center (FQHC) 7517102478 Practice locations: Parma, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1417464504. Details of each certification follow.

Federally qualified health center certification: CCN 361173

Legal name
CIRCLE HEALTH SERVICES
Doing business as
HEALTH AND WELLNESS SOUTHWEST
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 22, 2018
Last certification
Jun 22, 2018
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 7, 1970 in OH
Enrollment address
5955 Ridge Rd
Parma, OH 44129-3936

Other NPIs with the same Medicare PAC ID 6

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

National Provider Directory

National Provider Directory
Tax ID family
Circle Health Services36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

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

View all 35

Ownership & related parties

All disclosed owners & managing parties 25

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

NameRoleSinceShare
Brinton Lincoln Individual Corporate DirectorBoard of Directors Nov 1, 2017 5%
Pamela Lerose Individual Corporate DirectorBoard Member Nov 18, 2022 5%
Kamaal Shakkour Individual Corporate OfficerTreasurer Feb 25, 2022 5%
Venyce Sanders Individual Corporate DirectorBoard Member Jan 27, 2023 5%
Susan Yarborough Individual Corporate DirectorBoard Member Oct 28, 2022 5%
Matthew Litzler Individual Corporate DirectorBoard of Directors Nov 1, 2017 5%
Manuela Serrat Individual Corporate DirectorBoard Member Oct 28, 2022 5%
Daniel S Blain Individual Corporate DirectorBoard of Directors Nov 1, 2017 5%
Bradley Ouambo Individual Corporate DirectorBoard Member Oct 28, 2022 5%
Camille Billups Individual Corporate DirectorBoard Member Nov 16, 2017 5%
James Crane Individual Corporate DirectorBoard Member May 23, 2023 5%
Eric Morse Individual W-2 Managing EmployeeCeo Apr 1, 2020
Christine Gambatese Individual Corporate OfficerChief Financial Officer Feb 1, 2022
Lisa Goods Individual Corporate DirectorBoard Member Nov 18, 2022 5%
Marla Fleischer Individual Corporate DirectorBoard Member Nov 16, 2017 5%
Tatiana Wells Individual Corporate DirectorBoard Member Jun 14, 2022 5%
Robert Faxon Individual Corporate DirectorBoard Member May 23, 2023 5%
Angela Beasley-Fielding Individual Corporate DirectorBoard Member Oct 26, 2018 5%
David H. Gunning Individual Corporate DirectorBoard Member Jun 14, 2022 5%
Tracey N Mason Individual Corporate DirectorBoard Member Nov 18, 2022 5%
Circle Health Services Organization, Parma, OH Non-profit Operational/Managerial Control Nov 1, 2017 5%
Lisa Forbes Individual Corporate DirectorBoard of Directors Nov 1, 2017 5%
Seth M Wolf Individual Corporate DirectorBoard of Directors Nov 1, 2017 5%
Moses Jhirad Individual Corporate DirectorBoard Member Jun 14, 2022 5%
Stephen McHale Individual Corporate DirectorBoard of Directors Nov 1, 2017 5%

Owners & managing parties with NPI records 6

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

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Health and Wellness EastCleveland, OH, CCN 361163 Federally qualified health center Operational/Managerial Control (100%) Nov 1, 2017
Health and Wellness Gordon SquareCleveland, OH, CCN 361172 Federally qualified health center Operational/Managerial Control (5%) Jan 1, 2018
Health and Wellness WestCleveland, OH, CCN 361182 Federally qualified health center Operational/Managerial Control (5%) Nov 1, 2017
OchinCleveland, OH, CCN D21089 Federally qualified health center 5% Or Greater Direct Ownership Interest (5%) Nov 1, 2017

Owned or controlled facilities with NPI records 12

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

Facilities with the same owner 4

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

NPI Registry JSON

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

{
    "created_epoch": "1515542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715040000000",
    "number": "1417464504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5955 RIDGE RD",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441293936",
            "telephone_number": "440-888-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5955 RIDGE RD",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441293936",
            "telephone_number": "440-888-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CIRCLE HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-10",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A",
        "authorized_official_last_name": "GAMBATESE",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "440-667-9805",
        "authorized_official_credential": "CPA"
    },
    "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": "0291120",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Free Medical Clinic of Greater Cleveland",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Parma, OH

Sources for this page

Verify at the official NPI Registry.