NPIMap

Organization Active NPI

Project Vida Health Center

Doing business as Mountain View High School

  • Federally Qualified Health Center (FQHC)
  • El Paso, TX
National Provider Identifier
1639810740
Registry record updated Feb 27, 2023
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
Doing business as
Mountain View High School
Practice address
14964 Greg Dr
El Paso, TX 79938-9213
Phone
(915) 465-1191
NPI assigned
Apr 5, 2022
Last updated
Feb 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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) 533-7057

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X NU
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

14964 Greg Dr
El Paso, TX 79938-9213

Mailing address

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

Other names 1

  • Mountain View High School Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230213001726 TX Part A Provider - Federally Qualified Health Center (FQHC) 4486614765 Practice locations: El Paso, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1639810740. Details of each certification follow.

Federally qualified health center certification: CCN 971003

Legal name
PROJECT VIDA HEALTH CENTER
Doing business as
MOUNTAIN VIEW HIGH SCHOOL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 30, 2022
Last certification
Dec 30, 2022
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 30, 2003 in TX
Enrollment address
14964 Greg Dr
El Paso, TX 79938-9213

Other NPIs with the same Medicare PAC ID 10

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

National Provider Directory

National Provider Directory
Tax ID family
Project Vida Health Center Inc37 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

Ownership & related parties

All disclosed owners & managing parties 14

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 DirectorBoard Member Jan 1, 2018
Rene Rocha Individual Corporate DirectorCfo Apr 1, 2021
Karol J Brito Individual Corporate DirectorBoard Member 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 DirectorSecretary of the Board Jan 1, 2018
Noelia Mendoza Individual Corporate DirectorBoard Member Oct 1, 2018
Andrew Velazquez Individual Corporate DirectorBoard Member Sep 1, 2018
Steve M Wagner Individual Corporate DirectorBoard Member Jan 1, 2016
Project Vida Health Center Organization, El Paso, TX Corporation Other Jan 1, 2022
Jesus Gonzales Individual Corporate DirectorBoard Member Jan 1, 2016
Carlos J Cluggy - Soto Individual Corporate DirectorTreasurer Jan 1, 2017
Ira N Locke Individual Corporate DirectorBoard Member Jan 1, 2017
Luis Raul Garza Individual Corporate DirectorMedical Director Jan 1, 2014
Lee Ann Bondurant Individual Corporate DirectorChairman of the Board Jan 1, 2017

Owners & managing parties with NPI records 12

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

All facility ownership & control disclosures 1

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

Owned or controlled facilities with NPI records 1

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

NPI Registry JSON

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677456000000",
    "number": "1639810740",
    "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": "14964 GREG DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799389213",
            "telephone_number": "915-465-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROJECT VIDA HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-05",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "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": "915-533-7057"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain View High School",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mountain View High School",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.