NPIMap

Organization Active NPI

Clinica de Salud del Valle de Salinas

  • Federally Qualified Health Center (FQHC)
  • Gonzalez, CA
National Provider Identifier
1689048241
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CLINICA DE SALUD DEL VALLE DE SALINAS
Practice address
126 Fifth Street
Gonzalez, CA 93926
Phone
(831) 757-8689
NPI assigned
Nov 19, 2015
Last updated
Jun 6, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
CLINICA DE SALUD DEL VALLE DE SALINASAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Authorized official

Name
Dr. Maximilliano Cuevas, MD
Title
Ceo/MD
Phone
(831) 757-8689

Specialties & licenses 1

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

Addresses

Primary practice location

126 Fifth Street
Gonzalez, CA 93926

Mailing address

55 Plaza Cir Ste a
Salinas, CA 93901-2952

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20081118000667 CA Part B Supplier - Clinic/Group Practice 3678513736 Receives reassigned benefits from 71 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Castroville, CA; Gonzales, CA; Greenfield, CA; King City, CA; Royal Oaks, CA; Salinas, CA; Soledad, CA
O20170707001604 CA Part A Provider - Federally Qualified Health Center (FQHC) 3678513736 Practice locations: Gonzales, CA
O20221027001088 CA Part A Provider - Federally Qualified Health Center (FQHC) 3678513736 Practice locations: Salinas, CA

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1689048241. Details of each certification follow.

Federally qualified health center certification: CCN 751982

Legal name
CLINICA DE SALUD DEL VALLE DE SALINAS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 7, 2017
Last certification
Jul 7, 2017
Ownership / control type
Non-profit – church related
Organization structure
CorporationNon-profit
Incorporated
Jul 9, 1988 in CA
Enrollment address
126 5TH Street
Gonzales, CA 93926

Federally qualified health center certification: CCN A01118

Legal name
CLINICA DE SALUD DEL VALLE DE SALINAS
Doing business as
CSVS - PLAZA CIRCLE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 18, 2022
Last certification
Oct 18, 2022
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
55 Plaza Cir
Salinas, CA 93901-2952

Other NPIs with the same Medicare PAC ID 9

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

Other NPIs on the same Medicare enrollment 11

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

National Provider Directory

National Provider Directory
Tax ID family
Rafael O Siqueiros MD9 organizations share this tax ID, including this one
Part of
Rafael O Siqueiros MD

Other organizations with this tax ID 8

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

Locations

10561 Merritt St
Castroville, CA 95012
Phone (831) 633-1514

223 Bassett St
King City, CA 93930
Phone (831) 385-5944

29 Bishop St
Ste A
Royal Oaks, CA 95076
Phone (831) 728-2505

2180 N Main St
Salinas, CA 93906
Phone (831) 443-2190

430 Airport Blvd
Salinas, CA 93905

55 Plaza Cir
Salinas, CA 93901
Phone (831) 500-6960

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Maximiliano Cuevas Individual Corporate DirectorCeo Jan 1, 2015
Operational/Managerial ControlCeo Jan 1, 2015
Corporate OfficerChief Executive Officer Jan 1, 2015
W-2 Managing EmployeeChief Executive Officer Jan 1, 2015
Michael Victor Individual W-2 Managing EmployeeController Jan 14, 2019
Ruben Jimenez Individual W-2 Managing EmployeeBilling Manager Sep 5, 2018
Jesus Lopez Individual Corporate DirectorBoard Member Jan 1, 2015
Rogelio Jacinto Individual Corporate DirectorBoard Member Jan 1, 2015
Corporate DirectorBoard Member Apr 2, 1998
Raymond Gonzalez Individual Corporate DirectorBoard Member Jan 1, 2015
Corporate DirectorBoard Member Apr 1, 2001
Maria Aguilar Individual Corporate DirectorBoard Member Jan 1, 2015
Corporate DirectorBoard Member May 1, 1998
Genaro Carlos Individual Corporate DirectorBoard Member Jan 1, 2015
Corporate DirectorBoard Member Feb 1, 2002
Victoria Coley Individual Corporate DirectorBoard Member Feb 7, 2019
Corporate DirectorBoard Member Feb 1, 2020
Ali Chavez Individual Corporate DirectorBoard Member Jan 1, 2015
Corporate DirectorBoard Member Oct 5, 1998
Elizabeth Reyes Individual Corporate DirectorBoard Member Jan 1, 2015
Corporate DirectorBoard Member Apr 5, 1998
Aurelio Gonzalez Individual Corporate DirectorBoard Member Jan 1, 2015
Corporate DirectorBoard Member Jul 1, 2010
Silvana Fiege Individual W-2 Managing EmployeeBilling Supervisor Jan 1, 2015
Josefina Rodriguez Individual Corporate DirectorBoard Member Jan 1, 2015
Criselia Serrano Individual Corporate DirectorBoard Member Jan 1, 2015
Corporate DirectorBoard Member Apr 5, 1998
Clinica de Salud del Valle de Salinas Organization, Salinas, CA Corporation Operational/Managerial Control Aug 1, 2022

Owners & managing parties with NPI records 10

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

Practitioners & affiliated clinicians

Practitioners 24

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 24

NPI Registry JSON

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

{
    "created_epoch": "1447891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717632000000",
    "number": "1689048241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 PLAZA CIR STE A",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939012952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 FIFTH STREET",
            "city": "GONZALEZ",
            "state": "CA",
            "postal_code": "93926",
            "telephone_number": "831-757-8689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA DE SALUD DEL VALLE DE SALINAS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLINICA DE SALUD DEL VALLE DE SALINAS",
        "enumeration_date": "2015-11-19",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A",
        "authorized_official_last_name": "CUEVAS",
        "authorized_official_first_name": "MAXIMILLIANO",
        "authorized_official_title_or_position": "CEO/MD",
        "authorized_official_telephone_number": "831-757-8689",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gonzalez, CA

Sources for this page

Verify at the official NPI Registry.