NPIMap

Organization Active NPI

Project Vida Health Center

  • Federally Qualified Health Center (FQHC)
  • San Elizario, TX
National Provider Identifier
1609699206
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PROJECT VIDA HEALTH CENTER
Practice address
200 Herring Road
San Elizario, TX 79849
Phone
(915) 465-1191
NPI assigned
Nov 4, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Authorized official

Name
William David Schlesinger
Title
Ceo
Phone
(915) 465-1191

Specialties & licenses 1

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

Addresses

Primary practice location

200 Herring Road
San Elizario, TX 79849

Mailing address

3607 Rivera Ave
El Paso, TX 79905-2415
Phone (915) 465-1191

Other names 1

  • Sambrano Elementary Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241120003420 TX Part A Provider - Federally Qualified Health Center (FQHC) 4486614765 Practice locations: San Elizario, TX

Federally qualified health center certification: CCN 971037

Legal name
PROJECT VIDA HEALTH CENTER
Doing business as
SAMBRANO ELEMENTARY SCHOOL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 14, 2024
Last certification
Nov 14, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
200 Herring Road
San Elizario, TX 79849

All disclosed owners & managing parties 13

Medicare enrollment files

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

NameRoleSinceShare
Patrick Bramblett Individual Corporate Director Jan 1, 2018
Rene Rocha Individual Corporate Director Apr 1, 2021
Karol J Brito Individual Corporate Director Oct 1, 2018
William Schlesinger Individual Corporate OfficerCeo Jan 1, 2004
Corporate DirectorCeo Jan 1, 2004
W-2 Managing EmployeeCeo Jan 1, 2004
Melanie a Matthys Individual Corporate Director Jan 1, 2018
Noelia Mendoza Individual Corporate Director Oct 1, 2018
Andrew Velazquez Individual Corporate Director Sep 1, 2018
Steve M Wagner Individual Corporate Director Jan 1, 2016
Jesus Gonzales Individual Corporate Director Jan 1, 2016
Carlos J Cluggy - Soto Individual Corporate Director Jan 1, 2017
Ira N Locke Individual Corporate Director Jan 1, 2017
Luis Raul Garza Individual Corporate Director Jan 1, 2014
Lee Ann Bondurant Individual Corporate Director Jan 1, 2017

All facility ownership & control disclosures 2

Medicare enrollment files

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

FacilityTypeRoleSince
Montana Vista Health CenterEl Paso, TX, CCN 671927 Federally qualified health center Other Jan 1, 2022
Mountain View High SchoolEl Paso, TX, CCN 971003 Federally qualified health center Other Jan 1, 2022

National Provider Directory

National Provider Directory
Tax ID family
Project Vida Health Center37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

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

View all 36

Owners & managing parties with NPI records 2

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

Owned or controlled facilities with NPI records 2

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

Other NPIs with the same Medicare PAC ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1730678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730678400000",
    "number": "1609699206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3607 RIVERA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799052415",
            "telephone_number": "915-465-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HERRING ROAD",
            "city": "SAN ELIZARIO",
            "state": "TX",
            "postal_code": "79849",
            "telephone_number": "915-465-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROJECT VIDA HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-04",
        "last_updated": "2024-11-04",
        "certification_date": "2024-10-30",
        "status": "A",
        "authorized_official_last_name": "SCHLESINGER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "915-465-1191"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sambrano Elementary",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Elizario, TX

Sources for this page

Verify at the official NPI Registry.