NPIMap

Organization Active NPI

Virginia Garcia Memorial Health Center

  • Federally Qualified Health Center (FQHC)
  • Hillsboro, OR
National Provider Identifier
1568624849
Registry record updated Aug 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
VIRGINIA GARCIA MEMORIAL HEALTH CENTER
Practice address
226 SE 8TH Ave
Hillsboro, OR 97123-4218
Phone
(503) 601-7400
NPI assigned
Jun 27, 2008
Last updated
Aug 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2023

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

Authorized official

Name
Annmarie Dennis
Title
Corporate Compliance Officer
Phone
(503) 214-1652

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

226 SE 8TH Ave
Hillsboro, OR 97123-4218

Mailing address

PO Box 6149
Aloha, OR 97007-0149

Other identifiers 1

IdentifierTypeStateIssuer
023197MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031211000992 OR Part B Supplier - Clinic/Group Practice 7113823881 Receives reassigned benefits from 168 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Willamina, OR; Beaverton, OR; Sheridan, OR; Newberg, OR; McMinnville, OR; Hillsboro, OR; Cornelius, OR
O20070703000745 OR Part A Provider - Federally Qualified Health Center (FQHC) 7113823881 1 other NPI on this enrollment
Practice locations: Hillsboro, OR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1568624849. Details of each certification follow.

Federally qualified health center certification: CCN 381900

Legal name
VIRGINIA GARCIA MEMORIAL HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 4, 2007
Last certification
Oct 4, 2007
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Jul 31, 1978 in OR
Enrollment address
226 SE 8TH Avenue
Hillsboro, OR 97123-4218

Other NPIs with the same Medicare PAC ID 9

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

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

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
Susan Felstiner Individual Corporate DirectorBoard Treasurer Oct 23, 2013
Jessica Ann Kitt Individual Corporate DirectorBoard Secretary Aug 23, 2017
Annmarie Dennis Individual W-2 Managing Employee Apr 16, 2018
Gilles Martin Munoz Individual Corporate Officer Jun 20, 2007
Rafal Decker Individual Corporate DirectorBoard Member Jun 24, 2015
Joaquin Borrego Individual Corporate Director Sep 23, 2020
Michael Yates Individual Corporate Director Jul 24, 2019
Alejandra Aguilar Individual Corporate DirectorBoard Member Aug 1, 2010
Araceli Gaytan Individual Corporate Officer Jul 18, 2007
Ricardo Palazuelos Individual Corporate DirectorBoard Vice Chair Oct 23, 2013
Laurel Durham Individual Corporate Director Feb 28, 2018
Mary Ludlum Individual Corporate Director Mar 25, 2020
Ketan Sampt Individual Corporate Director Jul 24, 2019

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Virginia Garcia Memorial Health CenterNewberg, OR, CCN 381947 Federally qualified health center Operational/Managerial Control Feb 28, 2014
Virginia Garcia Memorial Health CenterHillsboro, OR, CCN 381956 Federally qualified health center Operational/Managerial Control Feb 28, 2014
Virginia Garcia Memorial Health CenterHillsboro, OR, CCN 381010 Federally qualified health center Operational/Managerial Control May 2, 2022

Owned or controlled facilities with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 6

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": "1214524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692403200000",
    "number": "1568624849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6149",
            "city": "ALOHA",
            "state": "OR",
            "postal_code": "970070149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 SE 8TH AVE",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971234218",
            "telephone_number": "503-601-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRGINIA GARCIA MEMORIAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-27",
        "last_updated": "2023-08-19",
        "certification_date": "2023-08-19",
        "status": "A",
        "authorized_official_last_name": "DENNIS",
        "authorized_official_first_name": "ANNMARIE",
        "authorized_official_title_or_position": "CORPORATE COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "503-214-1652"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023197",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

Verify at the official NPI Registry.