NPIMap

Organization Active NPI

Sac Health System

  • Federally Qualified Health Center (FQHC)
  • Murrieta, CA
National Provider Identifier
1548028962
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SAC HEALTH SYSTEM
Practice address
28078 Baxter Rd Ste 430
Murrieta, CA 92563-1404
Phone
(909) 382-7100
Fax
(909) 382-7101
NPI assigned
Mar 11, 2024
Last updated
Apr 21, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SAC HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Authorized official

Name
Tasha Amick
Title
Director of Billing
Phone
(909) 382-7100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

28078 Baxter Rd Ste 430
Murrieta, CA 92563-1404

Mailing address

250 S G St
San Bernardino, CA 92410-3320
Phone (909) 382-7100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250213000904 CA Part A Provider - Federally Qualified Health Center (FQHC) 4385533579 Practice locations: Murrieta, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1548028962. Details of each certification follow.

Federally qualified health center certification: CCN A01985

Legal name
SAC HEALTH SYSTEM
Doing business as
SAC MURRIETA SUITE 430
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 12, 2025
Last certification
Feb 12, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
28078 Baxter Rd
Ste 430
Murrieta, CA 92563-1404

Other NPIs with the same Medicare PAC ID 12

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

National Provider Directory

National Provider Directory
Tax ID family
Sac Health System Norto18 organizations share this tax ID, including this one
Part of
Sac Health System Norto

Other organizations with this tax ID 17

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

View all 17

Locations

28078 Baxter Rd
Ste 430
Murrieta, CA 92563
Phone (951) 290-4378

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Peter J Baker Individual Corporate Director Feb 22, 2022
Angela Teresi Individual W-2 Managing Employee Jun 29, 2015
Jason Lohr Individual Corporate OfficerCeo Jun 29, 2018
Pat Morris Individual Corporate Director Sep 24, 2019
Raul Castillo Individual Corporate Director Apr 1, 2014
Richard Henry Hart Individual Corporate Director Jul 1, 2014
Jordan Urban Individual Corporate Officer Dec 30, 2022
Rodney Neal Individual Corporate Director Sep 1, 2014
Jessica Garcia Individual Corporate Director Feb 22, 2022
Marilyn Hermann Individual Corporate Director Mar 1, 2010

Owners & managing parties with NPI records 2

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

NPI Registry JSON

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

{
    "created_epoch": "1710115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745193600000",
    "number": "1548028962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 S G ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924103320",
            "telephone_number": "909-382-7100",
            "fax_number": "909-382-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28078 BAXTER RD STE 430",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925631404",
            "telephone_number": "909-382-7100",
            "fax_number": "909-382-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAC HEALTH SYSTEM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAC HEALTH SYSTEM",
        "enumeration_date": "2024-03-11",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A",
        "authorized_official_last_name": "AMICK",
        "authorized_official_first_name": "TASHA",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING",
        "authorized_official_telephone_number": "909-382-7100"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrieta, CA

Sources for this page

Verify at the official NPI Registry.