NPIMap

Organization Active NPI

Alameda Health System

Doing business as Newark Health Center

  • Federally Qualified Health Center (FQHC)
  • Newark, CA
National Provider Identifier
1497956288
Registry record updated May 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
EXEMPT UNDER 12-35B Issued in CA
Legal business name
ALAMEDA HEALTH SYSTEM
Doing business as
Newark Health Center
Practice address
6066 Civic Terrace Ave
Newark, CA 94560-3746
Phone
(510) 505-1600
Fax
(510) 494-7210
NPI assigned
May 30, 2007
Last updated
May 27, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2016

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

Authorized official

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

Specialties & licenses 1

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

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 1

  • NEWARK HEALTH 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
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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1497956288. Details of each certification follow.

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
OtherNon-profit
Incorporated
in CA
Enrollment address
6066 Civic Terrace Ave
Newark, CA 94560-3746

Other NPIs on the same Medicare enrollment 12

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

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

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

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

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

470 27th St
Oakland, CA 94612
Phone (510) 267-8800

Ownership & related parties

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 OfficerChief Financial Officer Jul 14, 2014
Corporate DirectorChief Financial Officer Jul 14, 2014
W-2 Managing EmployeeChief 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 OfficerChief Administrative Officer Dec 5, 2011
W-2 Managing EmployeeChief 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 EmployeeAd; Nov 1, 2024
Michele Lawrence Individual Corporate Director Nov 20, 2012

Practitioners & affiliated clinicians

Practitioners 912

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 912

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464307200000",
    "number": "1497956288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15400 FOOTHILL BLVD",
            "address_2": "BLDG E",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945781009",
            "telephone_number": "510-895-7344",
            "fax_number": "510-895-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6066 CIVIC TERRACE AVE",
            "city": "NEWARK",
            "state": "CA",
            "postal_code": "945603746",
            "telephone_number": "510-505-1600",
            "fax_number": "510-494-7210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALAMEDA HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2016-05-27",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "BERNADETTE",
        "authorized_official_title_or_position": "VP OF REVENUE CYCLE",
        "authorized_official_telephone_number": "510-618-2147"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "EXEMPT UNDER 12-35B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NEWARK HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newark, CA

Sources for this page

Verify at the official NPI Registry.