NPIMap

Organization Active NPI

Last Frontier Healthcare District

Doing business as Modoc Medical Center

  • Rural Health Clinic/Center
  • Alturas, CA
National Provider Identifier
1487764064
Registry record updated Dec 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
LAST FRONTIER HEALTHCARE DISTRICT
Doing business as
Modoc Medical Center
Practice address
1111 N Nagle St
Alturas, CA 96101-3840
Phone
(530) 708-8801
Fax
(530) 233-6609
NPI assigned
Aug 30, 2006
Last updated
Dec 28, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2022

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

Authorized official

Name
Kevin Kramer
Title
Ceo
Phone
(530) 708-8801

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

1111 N Nagle St
Alturas, CA 96101-3840

Mailing address

PO Box 190
Alturas, CA 96101-0190
Phone (530) 708-8801

Other identifiers 2

IdentifierTypeStateIssuer
ZZZ13295ZOtherCABLUE SHIELD OF CALIFORNIA
RHM13988FMedicaidCA

Other names 1

  • Modoc Medical Center Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080104000277 CA Part A Provider - Critical Access Hospital 2466447412 Receives reassigned benefits from 41 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Alturas, CA
O20100504000332 CA Part A Provider - Rural Health Clinic 2466447412 Practice locations: Alturas, CA

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1487764064. Details of each certification follow.

Hospital certification: CCN 051330

Legal name
LAST FRONTIER HEALTHCARE DISTRICT
Doing business as
MODOC MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Oct 9, 2008
Last certification
Apr 24, 2025
Beds
8
Ownership / control type
Hospital district or authority
Most recent change of ownership
Aug 23, 2011 (1 total)
Organization structure
GovernmentNon-profit
Enrollment address
1111 N Nagle St
Alturas, CA 96101-3840
Other Hospital Practice Location

Rural health clinic certification: CCN 053988

Legal name
LAST FRONTIER HEALTHCARE DISTRICT
Doing business as
MODOC MEDICAL CENTER FAMILY PRACTICE CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 2, 1992
Last certification
May 14, 2014
Ownership / control type
Non-profit – church related
Organization structure
GovernmentNon-profit
Enrollment address
1111 N Nagle St
Alturas, CA 96101-3840
Related CCNs
051330

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Modoc Medical CenterCCN 051330 · All quality measures
Overall star rating
4 of 5
Type
Critical Access Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

229 W McDowell Ave
Alturas, CA 96101
Phone (530) 233-5131

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Carol a Madison Individual Corporate DirectorMember Board of Directors Jan 1, 2018
Corporate DirectorMember Board of Directors Jan 9, 2013
Last Frontier Healthcare District Organization, Alturas, CA 5% Or Greater Direct Ownership Interest Oct 12, 2010
5% Or Greater Direct Ownership Interest Aug 23, 2011 100%
Kevin Kramer Individual Corporate OfficerChief Executive Officer Jul 21, 2013
Operational/Managerial ControlChief Executive Officer Jul 21, 2013
Edouard J Cavasso Individual Corporate DirectorVice Chair Board of Directors Jan 9, 2013
Patrick J Fields Individual Corporate OfficerFinance Director Aug 28, 2017
W-2 Managing EmployeeFinance Director Aug 28, 2017
Corporate OfficerChief Financial Officer Aug 28, 2018
Edward P Richert Individual Contracted Managing Employee Dec 7, 2007
Corporate OfficerVice Chief of Staff Jun 1, 2012

Owners & managing parties with NPI records 5

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
Modoc Medical CenterAlturas, CA, CCN 051330 Hospital 5% Or Greater Direct Ownership Interest Oct 12, 2010
Modoc Medical CenterAlturas, CA, CCN 05Z330 Hospital 5% Or Greater Direct Ownership Interest (100%) May 16, 2008
Last Frontier Healthcare DistrictAlturas, CA, CCN 555420 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Aug 23, 2011
Jan 1, 2010
Jan 1, 2010
Canby Family Practice ClinicCanby, CA, CCN 058714 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2020

Owned or controlled facilities with NPI records 3

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

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Practitioners 30

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 30

Affiliated clinicians 87

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 87

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672185600000",
    "number": "1487764064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "city": "ALTURAS",
            "state": "CA",
            "postal_code": "961010190",
            "telephone_number": "530-708-8801",
            "fax_number": "530-233-6609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 N NAGLE ST",
            "city": "ALTURAS",
            "state": "CA",
            "postal_code": "961013840",
            "telephone_number": "530-708-8801",
            "fax_number": "530-233-6609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAST FRONTIER HEALTHCARE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A",
        "authorized_official_last_name": "KRAMER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "530-708-8801"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "ZZZ13295Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM13988F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Modoc Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Modoc Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alturas, CA

Sources for this page

Verify at the official NPI Registry.