NPIMap

Organization Active NPI

Lumira Healthcare

Doing business as Modesto Florida Ave Center

  • Federally Qualified Health Center (FQHC)
  • Modesto, CA
National Provider Identifier
1649099151
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LUMIRA HEALTHCARE
Doing business as
Modesto Florida Ave Center
Practice address
1444 Florida Ave Ste 202
Modesto, CA 95350-4400
Phone
(209) 850-3500
Fax
(209) 850-3499
NPI assigned
Oct 10, 2024
Last updated
Sep 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Authorized official

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

Specialties & licenses 1

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

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 1

  • Modesto Florida Ave Center Doing business as

Medicare participation

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

Enrollment records 1

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1649099151. Details of each certification follow.

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
CorporationNon-profit
Enrollment address
1444 Florida Ave
Ste 202
Modesto, CA 95350-4400

Other NPIs with the same Medicare PAC ID 9

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

National Provider Directory

National Provider Directory
Tax ID family
James M Raveret MD10 organizations share this tax ID, including this one
Part of
James M Raveret MD

Other organizations with this tax ID 9

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

Locations

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

2412 3rd St
Ste B
Hughson, CA 95326
Phone (209) 558-7250

125 E 18th St
Merced, CA 95340

Ownership & related parties

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 DirectorBoard Member Jan 1, 2023
Jyotti Pannu Individual Corporate DirectorBoard Member May 1, 2019
Rajmeet Grewal Individual Corporate DirectorBoard Member Feb 27, 2025
Glen Villanueva Individual Corporate OfficerChief Medical Officer Nov 1, 2017
W-2 Managing EmployeeChief Medical Director Nov 1, 2017
Hilda Pimentel Individual Corporate DirectorBoard Secretary Jan 1, 2023
Leslie Abasta-Cummings Individual Corporate OfficerCeo Mar 12, 2012
W-2 Managing EmployeeCeo Mar 12, 2012
Emily Fleischmann Individual Corporate DirectorBoard Member Jan 1, 2023
Rosalinda Ruiz Individual Corporate DirectorBoard Member Jan 1, 2016
Mark Hendrickson Individual Corporate DirectorVice Chair Dec 1, 2020

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 91

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.

View all 91

NPI Registry JSON

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

{
    "created_epoch": "1728518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788307200000",
    "number": "1649099151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 B ST BLDG A-C",
            "city": "LIVINGSTON",
            "state": "CA",
            "postal_code": "953349593",
            "telephone_number": "209-850-3500",
            "fax_number": "209-850-3499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1444 FLORIDA AVE STE 202",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504400",
            "telephone_number": "209-850-3500",
            "fax_number": "209-850-3499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMIRA HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-10",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A",
        "authorized_official_last_name": "ABASTA-CUMMINGS",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "209-850-3500"
    },
    "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": "Modesto Florida Ave Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.