NPIMap

Organization Active NPI

Neighborhood Healthcare

Doing business as Neighborhood Healthcare - Ray M Dickinson Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Escondido, CA
National Provider Identifier
1437335353
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NEIGHBORHOOD HEALTHCARE
Doing business as
Neighborhood Healthcare - Ray M Dickinson Wellness Center
Practice address
425 N Date St
Escondido, CA 92025-3413
Phone
(760) 520-8330
Fax
(760) 737-9713
NPI assigned
Jan 10, 2008
Last updated
May 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Authorized official

Name
Rakesh Patel, MD,MBA,FAAFP,CPE
Title
Ceo
Phone
(760) 520-8300

Specialties & licenses 1

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

Addresses

Primary practice location

425 N Date St
Escondido, CA 92025-3413

Mailing address

215 S Hickory St
Escondido, CA 92025-4359

Other identifiers 2

IdentifierTypeStateIssuer
55-1173OtherCAMEDICARE PTAN
FHC70890FMedicaidCA

Other names 1

  • Neighborhood Healthcare - Ray M Dickinson Wellness Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121012000721 CA Part A Provider - Federally Qualified Health Center (FQHC) 5294649406 Practice locations: Escondido, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1437335353. Details of each certification follow.

Federally qualified health center certification: CCN 551173

Legal name
NEIGHBORHOOD HEALTHCARE
Doing business as
NEIGHBORHOOD HEALTHCARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 12, 2012
Last certification
Oct 12, 2012
Ownership / control type
Non-profit – church related
Organization structure
CorporationNon-profit
Incorporated
Oct 25, 1972 in CA
Enrollment address
425 N Date St
Escondido, CA 92025-3412

National Provider Directory

National Provider Directory
Tax ID family
Neighborhood Healthcare- Pace Riverside40 organizations share this tax ID, including this one

Other organizations with this tax ID 39

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

View all 39

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Alan John Conrad Individual Corporate Director Mar 8, 2017
Federico Salas Individual Other Oct 1, 2010
Katherine Schafer Individual Other Oct 1, 2010
Rakesh R Patel Individual Corporate OfficerCeo Nov 1, 2017
Corporate DirectorCeo Nov 1, 2017
W-2 Managing EmployeeCeo Nov 1, 2017
Cabiria Lizarraga Individual Other Oct 1, 2010
Judith Descalso Individual Other Oct 1, 2012
Nasir Al Sammaraie Individual Corporate Director Dec 9, 2015
Thomas Jenkins Individual Corporate Director Jan 10, 2019
Neighborhood Healthcare Organization, Escondido, CA Non-profit Operational/Managerial Control Oct 1, 2010
William Smith Individual Corporate Director Jun 14, 2017
Christopher Cruz Individual Corporate Director Nov 10, 2021
Lisa Misraje Individual OtherBoard Member Director Apr 27, 2022
Jesse Renteria Individual OtherBoard Member Director Jul 12, 2023
Dolores Campillo Individual OtherBoard Member Director Oct 1, 2024
Laura Nunn Individual Corporate Director Feb 13, 2019

Owners & managing parties with NPI records 2

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

All facility ownership & control disclosures 20

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

FacilityTypeRoleSince
Neighborhood Healthcare - EscondidoEscondido, CA, CCN 551866 Federally qualified health center Operational/Managerial Control Nov 12, 1999
Neighborhood Healthcare - PediatricsEscondido, CA, CCN 551065 Federally qualified health center Operational/Managerial Control Oct 1, 2010
Neighborhood Healthcare LakesideLakeside, CA, CCN 551077 Federally qualified health center Operational/Managerial Control Oct 1, 2010
Neighborhood Healthcare Valley ParkwayEscondido, CA, CCN 551080 Federally qualified health center Operational/Managerial Control Oct 1, 2010
El CajonEl Cajon, CA, CCN 551079 Federally qualified health center Operational/Managerial Control Oct 1, 2010
TemeculaTemecula, CA, CCN 551091 Federally qualified health center Operational/Managerial Control Oct 1, 2010
Neighborhood Healthcare- MenifeeMenifee, CA, CCN 751154 Federally qualified health center Operational/Managerial Control Mar 12, 2015
Neighborhood HealthcareHemet, CA, CCN 751920 Federally qualified health center Operational/Managerial Control Mar 1, 2017
Neighborhood Healthcare - PrenatalEscondido, CA, CCN 921141 Federally qualified health center Operational/Managerial Control Apr 1, 2019
Neighborhodd Healthcare- Gold Family Health CenterPoway, CA, CCN 921149 Federally qualified health center Operational/Managerial Control Jun 1, 2019
Neighborhood Healthcare Temecula ParkwayTemecula, CA, CCN A01086 Federally qualified health center Operational/Managerial Control Jul 24, 2020
Neighborhood Healthcare Downtown EscondidoEscondido, CA, CCN A01090 Federally qualified health center Operational/Managerial Control Apr 25, 2022
Neighborhood Healthcare- FallbrookFallbrook, CA, CCN A01100 Federally qualified health center Operational/Managerial Control May 3, 2018
Neighborhood Healthcare - Washington AveEscondido, CA, CCN A01104 Federally qualified health center Operational/Managerial Control Sep 1, 2019
Neighborhood Healthcare Menifee Suite CMenifee, CA, CCN A01121 Federally qualified health center Operational/Managerial Control Aug 8, 2019
Neighborhood Healthcare- Arlanza Family Health CenterRiverside, CA, CCN A01162 Federally qualified health center Operational/Managerial Control Oct 1, 2010
Neighborhood Healthcare- Eastside Health Center BLDG. BRiverside, CA, CCN A01157 Federally qualified health center Operational/Managerial Control Oct 1, 2010
Neighborhood HealthcareSan Marcos, CA, CCN A01158 Federally qualified health center Operational/Managerial Control Aug 5, 2022
Neighborhood Healthcare- RiversideRiverside, CA, CCN A01159 Federally qualified health center Operational/Managerial Control Oct 1, 2010
Neighborhood Healthcare - MollisonEl Cajon, CA, CCN A01834 Federally qualified health center Operational/Managerial Control (100%) Jul 17, 2023

Facilities with the same owner 20

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

View all 20

Practitioners & affiliated clinicians

Practitioners 25

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 25

NPI Registry JSON

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

{
    "created_epoch": "1199923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717027200000",
    "number": "1437335353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 S HICKORY ST",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920254359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 N DATE ST",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920253413",
            "telephone_number": "760-520-8330",
            "fax_number": "760-737-9713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEIGHBORHOOD HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-10",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "RAKESH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "760-520-8300",
        "authorized_official_credential": "MD,MBA,FAAFP,CPE"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "55-1173",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC70890F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neighborhood Healthcare - Ray M Dickinson Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Neighborhood Healthcare - Ray M Dickinson Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Escondido, CA

Sources for this page

Verify at the official NPI Registry.