NPIMap

Organization Active NPI

Camarena Health

  • Urgent Care Clinic/Center
  • Madera, CA
National Provider Identifier
1508415274
Registry record updated Sep 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
CAMARENA HEALTH
Practice address
1159 Country Club Dr
Madera, CA 93638-1537
Phone
(559) 664-4000
NPI assigned
Sep 5, 2019
Last updated
Sep 26, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2019

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

Authorized official

Name
Luzvinda Gabriela Martinez
Title
Billing Supervisor
Phone
(559) 664-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

1159 Country Club Dr
Madera, CA 93638-1537

Mailing address

PO Box 299
Madera, CA 93639-0299
Phone (559) 664-4000

Other names 1

  • Camarena Health Country Club Urgent Care Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040318000523 CA Part B Supplier - Clinic/Group Practice 4880584317 Receives reassigned benefits from 178 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Oakhurst, CA; Madera, CA; Fresno, CA; Coarsegold, CA; Chowchilla, CA
O20200611000439 CA Part A Provider - Federally Qualified Health Center (FQHC) 4880584317 Practice locations: Madera, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1508415274. Details of each certification follow.

Federally qualified health center certification: CCN 921856

Legal name
CAMARENA HEALTH
Doing business as
CAMARENA HEALTH COUNTRY CLUB URGENT CARE
Organization structure
CorporationNon-profit
Incorporated
Jul 21, 1978 in CA
Enrollment address
1159 Country Club Dr
Madera, CA 93638-1537

Other NPIs with the same Medicare PAC ID 23

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

View all 23

Other NPIs on the same Medicare enrollment 16

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

View all 16

National Provider Directory

National Provider Directory
Tax ID family
Darin M Camarena Health25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

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

View all 24

Locations

1157 Country Club Dr
#A
Madera, CA 93638

1159 Country Club Dr
Madera, CA 93638

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Patty Thompson Individual Corporate DirectorBoard Member Dec 1, 2023
Martha Cardona Individual Corporate DirectorBoard Member Vice President May 23, 2018
Edgar Jimenez Individual Corporate DirectorBoard Member Jul 16, 2013
Paulo a Soares Individual Corporate OfficerChief of Executive Officer Feb 1, 2011
Monic Asenjo-Wilhite Individual Corporate DirectorBoard Member President Jan 24, 2001
Seann Garcia Individual Corporate DirectorBoard Member Nov 16, 2011
Virginia M Lane-Pacheco Individual Corporate DirectorBoard Member Jan 1, 2025
Oracio M Rodriguez Individual Corporate DirectorBoard Member Jan 1, 2025
Abimael Vargas Individual Corporate DirectorBoard Member May 25, 2011
Christine N Howland Individual Corporate OfficerChief Operations Officer Apr 11, 2011 25%
W-2 Managing EmployeeChief of Operations Apr 11, 2011
Raquel Rodarte Individual Corporate DirectorBoard Member Secretary Jan 1, 2015
Bruce Alamedia Individual Corporate DirectorBoard Treasurer Jan 1, 2022

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569456000000",
    "number": "1508415274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 299",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936390299",
            "telephone_number": "559-664-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1159 COUNTRY CLUB DR",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936381537",
            "telephone_number": "559-664-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMARENA HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-05",
        "last_updated": "2019-09-26",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "LUZVINDA",
        "authorized_official_middle_name": "GABRIELA",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "559-664-4000"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Camarena Health Country Club Urgent Care",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Camarena Health Country Club Urgent Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Madera, CA

Sources for this page

Verify at the official NPI Registry.