NPIMap

Organization Active NPI

Hi-Desert Memorial Health Care District

Doing business as Morongo Basin Community Health Center-BH

  • Federally Qualified Health Center (FQHC)
  • Yucca Valley, CA
National Provider Identifier
1649708611
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HI-DESERT MEMORIAL HEALTH CARE DISTRICT
Doing business as
Morongo Basin Community Health Center-BH
Morongo Basin Healthcare District
Practice address
58383 29 Palms Hwy Ste 101
Yucca Valley, CA 92284-5891
Phone
(760) 365-9305
Fax
(866) 732-0113
NPI assigned
Jun 2, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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

Authorized official

Name
Cindy Schmall
Title
Ceo
Phone
(760) 979-4276

Specialties & licenses 1

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

Addresses

Primary practice location

58383 29 Palms Hwy Ste 101
Yucca Valley, CA 92284-5891

Mailing address

6530 La Contenta Rd Ste 100
Yucca Valley, CA 92284-7313
Phone (760) 820-9229

Other names 2

  • Morongo Basin Community Health Center-BH Doing business as
  • Morongo Basin Healthcare District Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041201001069 CA Part B Supplier - Clinic/Group Practice 1254240898 Receives reassigned benefits from 20 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Twentynine Palms, CA; Yucca Valley, CA
O20170630001130 CA Part A Provider - Federally Qualified Health Center (FQHC) 1254240898 Practice locations: Yucca Valley, CA

Federally qualified health center certification: CCN 751975

Legal name
HI-DESERT MEMORIAL HEALTH CARE DISTRICT
Doing business as
MORONGO BASIN COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 27, 2017
Last certification
Jun 27, 2017
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Enrollment address
58383 29 Palms Hwy
Ste 101
Yucca Valley, CA 92284-5891

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Hi-Desert Emergency Roo4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

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
Hi-Desert Memorial Health Care District Organization, Yucca Valley, CA Non-profit Operational/Managerial Control Jul 15, 2015 100%
Cynthia a Schmall Individual Corporate OfficerChief Executive Officer Dec 2, 2021 100%
Operational/Managerial ControlChief Executive Officer Dec 2, 2021 100%

Owners & managing parties with NPI records 2

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Morongo Basin Healthcare DistrictYucca Valley, CA, CCN 751072 Federally qualified health center Operational/Managerial Control (100%) Jul 1, 2015
Morongo Basin Community Health Center-29Twentynine Palms, CA, CCN 751073 Federally qualified health center Operational/Managerial Control (100%) Jul 1, 2021

Owned or controlled facilities with NPI records 2

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

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1496361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673222400000",
    "number": "1649708611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6530 LA CONTENTA RD STE 100",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "922847313",
            "telephone_number": "760-820-9229",
            "fax_number": "760-820-9228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58383 29 PALMS HWY STE 101",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "922845891",
            "telephone_number": "760-365-9305",
            "fax_number": "866-732-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HI-DESERT MEMORIAL HEALTH CARE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-02",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A",
        "authorized_official_last_name": "SCHMALL",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "760-979-4276"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Morongo Basin Community Health Center-BH",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Morongo Basin Healthcare District",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yucca Valley, CA

Sources for this page

Verify at the official NPI Registry.