Alameda Health System

Organization Active NPI Federally Qualified Health Center (FQHC) · Newark, CA

NPI 1497956288 · NPPES record last updated May 27, 2016

Key facts

NPI
1497956288
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
License
EXEMPT UNDER 12-35B (CA)
Legal business name
ALAMEDA HEALTH SYSTEM
Practice address
6066 Civic Terrace Ave
Newark, CA 94560-3746
Phone
(510) 505-1600
Fax
(510) 494-7210
NPI assigned
May 30, 2007
Organization subpart
No

Authorized official

Name
Bernadette Jensen
Title
VP of Revenue Cycle
Phone
(510) 618-2147

Other NPIs on the same Medicare enrollment 12

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

Practitioners 951

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

View all 951

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in CA

Federally qualified health center certification: CCN 751836

Legal name
ALAMEDA HEALTH SYSTEM
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 23, 2015
Last certification
Dec 23, 2015
Ownership / control type
Non-profit – corporation
Organization structure
Other · Non-profit
Incorporated
in CA
Enrollment address
6066 Civic Terrace Ave
Newark, CA 94560-3746

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Frederick J Devries
Individual
Corporate Officer Oct 8, 2013
Corporate Director Oct 8, 2013
David W Cox
Individual
Corporate Officer
Chief Financial Officer
Jul 14, 2014
Corporate Director
Chief Financial Officer
Jul 14, 2014
W-2 Managing Employee
Chief Financial Officer
Jul 14, 2014
Maria G Hernandez
Individual
Corporate Director Sep 9, 2014
Anthony B Varni
Individual
Corporate Director Mar 26, 2013
Tracy Jensen
Individual
Corporate Director Sep 9, 2014
James Lugannani
Individual
Corporate Director May 13, 2014
John T Chapman
Individual
Corporate Officer
Chief Administrative Officer
Dec 5, 2011
W-2 Managing Employee
Chief Administrative Officer
Dec 5, 2011
Barooyr F Zorthian
Individual
Corporate Director Feb 1, 2011
James E Jackson
Individual
Corporate Officer May 14, 2012
W-2 Managing Employee May 14, 2012
Kirk E Miller
Individual
Corporate Director Dec 19, 2006
Kinkini Banerjee
Individual
Corporate Director Oct 8, 2013
Shari Johnson
Individual
W-2 Managing Employee
Ad;
Nov 1, 2024
Michele Lawrence
Individual
Corporate Director Nov 20, 2012

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031110000764 CA Part B Supplier - Clinic/Group Practice 3779494521 Receives reassigned benefits from 973 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Alameda, CA; Castro Valley, CA; Hayward, CA; Newark, CA; Oakland, CA; San Leandro, CA
O20160119002180 CA Part a Provider - Federally Qualified Health Center (FQHC) 3779494521 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Newark, CA

National Provider Directory

Locations

2111 Whitehall Pl
Ste D
Alameda, CA 94501
Phone (510) 535-6957

2060 Fairmont Dr
Castro Valley, CA 94578
Phone (510) 346-1300

15400 Foothill Blvd
Ste H
Castro Valley, CA 94578
Phone (510) 895-4200

224 W Winton Ave
Hayward, CA 94544
Phone (510) 535-6957

24100 Amador St
Ste 250
Hayward, CA 94544
Phone (510) 266-1700

224 W Winton Ave
#113
Hayward, CA 94544
Phone (510) 881-6580

1411 E 31st St
Fl 1
Oakland, CA 94602
Phone (510) 545-2765

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X EXEMPT UNDER 12-35B CA Yes

Addresses

Primary practice location

6066 Civic Terrace Ave
Newark, CA 94560-3746

Mailing address

15400 Foothill Blvd
BLDG E
San Leandro, CA 94578-1009
Phone (510) 895-7344

Other names

  • NEWARK HEALTH CENTER Doing business as

Other providers in Newark, CA

All providers in Newark, CA · Federally Qualified Health Center (FQHC) in California

Sources for this page

Verify at the official NPI Registry.