NPIMap

Organization Active NPI

Community Health Center of Pinellas Inc

Doing business as Evara Health

  • Federally Qualified Health Center (FQHC)
  • St Petersburg, FL
National Provider Identifier
1609384700
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH CENTER OF PINELLAS INC
Doing business as
Evara Health
Practice address
4950 34TH St N
St Petersburg, FL 33714-3031
Phone
(727) 824-8181
NPI assigned
Jan 11, 2018
Last updated
Oct 17, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY HEALTH CENTER OF PINELLAS INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Authorized official

Name
Edward Kucher
Title
Chief Regulatory Officer
Phone
(727) 824-8100

Specialties & licenses 1

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

Addresses

Primary practice location

4950 34TH St N
St Petersburg, FL 33714-3031

Mailing address

PO Box 10549
St Petersburg, FL 33733-0549
Phone (727) 824-8181

Other identifiers 1

IdentifierTypeStateIssuer
029565525MedicaidFL

Other names 1

  • Evara Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040131000031 FL Part B Supplier - Clinic/Group Practice 8527961028 Receives reassigned benefits from 135 practitioners
18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Largo, FL; Tarpon Springs, FL; St Petersburg, FL; Saint Petersburg, FL; Pinellas Park, FL; Dunedin, FL; Clearwater, FL
O20180328000034 FL Part A Provider - Federally Qualified Health Center (FQHC) 8527961028 Practice locations: St Petersburg, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1609384700. Details of each certification follow.

Federally qualified health center certification: CCN 681122

Legal name
COMMUNITY HEALTH CENTER OF PINELLAS INC
Doing business as
COMMUNITY HEALTH CENTER AT LEALMAN
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 28, 2018
Last certification
Mar 28, 2018
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Nov 14, 1980 in FL
Enrollment address
4950 34TH St N
St Petersburg, FL 33714-3031

Other NPIs with the same Medicare PAC ID 19

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

View all 19

Other NPIs on the same Medicare enrollment 18

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

View all 18

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2145637Evara Health4950 34TH St N, Saint Petersburg, FL 33714Provider-performed microscopyMar 12, 2028

National Provider Directory

National Provider Directory
Tax ID family
Community Health Center of Pinellas Inc24 organizations share this tax ID, including this one
Part of
Community Health Center of Pinellas Inc

Other organizations with this tax ID 23

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

View all 23

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Elodie Dorso Individual Corporate Director Feb 2, 2018
W-2 Managing EmployeeCeo Jan 1, 2005
Edward Kucher Individual Corporate DirectorCoo Feb 2, 2018
W-2 Managing EmployeeCoo Feb 27, 2017

Practitioners & affiliated clinicians

Practitioners 2

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": "1515628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729123200000",
    "number": "1609384700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10549",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337330549",
            "telephone_number": "727-824-8181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4950 34TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337143031",
            "telephone_number": "727-824-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTER OF PINELLAS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY HEALTH CENTER OF PINELLAS INC",
        "enumeration_date": "2018-01-11",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A",
        "authorized_official_last_name": "KUCHER",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "CHIEF REGULATORY OFFICER",
        "authorized_official_telephone_number": "727-824-8100"
    },
    "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": "029565525",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evara Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.