NPIMap

Organization Active NPI

Ampla Health

  • Federally Qualified Health Center (FQHC)
  • Hamilton City, CA
National Provider Identifier
1689699415
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
230000196 Issued in CA
Legal business name
AMPLA HEALTH
Practice address
278 Main St.
Hamilton City, CA 95951
Phone
(530) 826-3694
Fax
(530) 826-3120
NPI assigned
Jul 13, 2006
Last updated
Feb 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Authorized official

Name
Mr. Benjamin H Flores, MPH
Title
President, Chief Executive Officer
Phone
(530) 751-3778

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 230000196 CA Primary
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

278 Main St.
Hamilton City, CA 95951

Mailing address

PO Box Ad
Yuba City, CA 95992-1396
Phone (530) 751-3778

Other identifiers 3

IdentifierTypeStateIssuer
HAP80230FOtherCAFAMILY PLANNING
FHC80230FMedicaidCA
BCP80230FOtherCAEWC:CDP:BCEDP

Other names 1

  • AMPLA HEALTH HAMILTON CITY MEDICAL Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040225001116 CA Part B Supplier - Clinic/Group Practice 5092619270 Receives reassigned benefits from 154 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Yuba City, CA; Chico, CA; Oroville, CA; Orland, CA; Olivehurst, CA; Los Molinos, CA; Hamilton City, CA; Gridley, CA…
O20060201000765 CA Part A Provider - Federally Qualified Health Center (FQHC) 5092619270 Practice locations: Hamilton City, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1689699415. Details of each certification follow.

Federally qualified health center certification: CCN 051809

Legal name
AMPLA HEALTH
Doing business as
AMPLA HEALTH HAMLTON CITY MEDICAL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 5, 1973 in CA
Enrollment address
278 Main Street
Hamilton City, CA 95951-0855

Other NPIs with the same Medicare PAC ID 16

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

View all 16

Other NPIs on the same Medicare enrollment 13

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

View all 13

National Provider Directory

National Provider Directory
Tax ID family
Richlands Family Health13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

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
Kim D Owens Individual Corporate DirectorBoard Member Apr 27, 2007
Benjamin H Flores Individual Corporate OfficerPresident and Ceo Apr 1, 2009 100%
J Angel Calderon Individual Corporate DirectorBoard Member Jan 31, 2012
Lorenzo Valdovinos Individual Corporate DirectorBoard Member Jan 15, 2018
Roberto B Gonzalez Individual Corporate DirectorBoard Member Jul 30, 2007
Elizabeth a Skelly Individual Corporate DirectorBoard Member Sep 25, 2012
Mark a Lundberg Individual Corporate DirectorBoard Member Jan 15, 2018
Alex T Lu Quin Individual Corporate DirectorBoard Members Jan 28, 2014
Horacio Paras Individual Corporate DirectorBoard Member Jun 1, 2013
Vicki L Chissie Individual W-2 Managing EmployeeBilling Manager Mar 19, 2012
Michele L Walters Individual Corporate DirectorBoard Member Sep 25, 2012
Debbie D Porcayo Individual Corporate DirectorBoard Member Oct 27, 2009
Wenceslao Vasquez Individual Corporate DirectorBoard Member Jan 28, 2004
Mary Jane Griego Individual Corporate DirectorBoard Member Jan 15, 2018

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 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709164800000",
    "number": "1689699415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX AD",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959921396",
            "telephone_number": "530-751-3778",
            "fax_number": "530-751-1237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "278 MAIN ST.",
            "city": "HAMILTON CITY",
            "state": "CA",
            "postal_code": "95951",
            "telephone_number": "530-826-3694",
            "fax_number": "530-826-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMPLA HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A",
        "authorized_official_last_name": "FLORES",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT, CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "530-751-3778",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPH"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "230000196",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY PLANNING",
            "identifier": "HAP80230F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC80230F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EWC:CDP:BCEDP",
            "identifier": "BCP80230F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AMPLA HEALTH HAMILTON CITY MEDICAL",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "AMPLA HEALTH HAMILTON CITY MEDICAL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hamilton City, CA

Sources for this page

Verify at the official NPI Registry.