Lumira Healthcare

Organization Active NPI Federally Qualified Health Center (FQHC) · Modesto, CA

NPI 1649099151 · NPPES record last updated Sep 2, 2026

Key facts

NPI
1649099151
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
LUMIRA HEALTHCARE
Practice address
1444 Florida Ave Ste 202
Modesto, CA 95350-4400
Phone
(209) 850-3500
Fax
(209) 850-3499
NPI assigned
Oct 10, 2024
Organization subpart
No

Authorized official

Name
Leslie Abasta-Cummings
Title
Ceo
Phone
(209) 850-3500

Owners & managing parties with NPI records 1

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

Other NPIs with the same Medicare PAC ID 9

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

Corporate family (same tax ID) 9

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

Practitioners 91

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 91

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Federally qualified health center certification: CCN A11025

Legal name
LIVINGSTON COMMUNITY HEALTH
Doing business as
MODESTO HEALTH CENTER-FLORIDA AVE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 17, 2025
Last certification
Nov 17, 2025
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Enrollment address
1444 Florida Ave
Ste 202
Modesto, CA 95350-4400

All disclosed owners & managing parties 9

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

NameRoleSinceShare
William Reichle
Individual
Corporate Director
Board Member
Jan 1, 2023
Jyotti Pannu
Individual
Corporate Director
Board Member
May 1, 2019
Rajmeet Grewal
Individual
Corporate Director
Board Member
Feb 27, 2025
Glen Villanueva
Individual
Corporate Officer
Chief Medical Officer
Nov 1, 2017
W-2 Managing Employee
Chief Medical Director
Nov 1, 2017
Hilda Pimentel
Individual
Corporate Director
Board Secretary
Jan 1, 2023
Leslie Abasta-Cummings
Individual
Corporate Officer
Ceo
Mar 12, 2012
W-2 Managing Employee
Ceo
Mar 12, 2012
Emily Fleischmann
Individual
Corporate Director
Board Member
Jan 1, 2023
Rosalinda Ruiz
Individual
Corporate Director
Board Member
Jan 1, 2016
Mark Hendrickson
Individual
Corporate Director
Vice Chair
Dec 1, 2020

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20251009003318 CA Part a Provider - Federally Qualified Health Center (FQHC) 8820084692 Practice locations: Modesto, CA

National Provider Directory

Tax ID family
Livingston Community Health (10 organizations share this tax ID)
Part of
Livingston Community Health

Locations

16233 King St
Delhi, CA 95315
Phone (209) 394-7913

7970 Lander Ave
Ste A
Hilmar, CA 95324
Phone (209) 262-1818

600 B St
Bldg B
Livingston, CA 95334
Phone (209) 299-6006

800 Delbon Ave
Turlock, CA 95382
Phone (209) 664-8000

Specialties & licenses

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

Addresses

Primary practice location

1444 Florida Ave Ste 202
Modesto, CA 95350-4400

Mailing address

600 B St BLDG a-C
Livingston, CA 95334-9593
Phone (209) 850-3500

Other names

  • Modesto Florida Ave Center Doing business as

Other providers in Modesto, CA

All providers in Modesto, CA · Federally Qualified Health Center (FQHC) in California

Sources for this page

Verify at the official NPI Registry.