NPIMap

Organization Active NPI

Unicare Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Apple Valley, CA
National Provider Identifier
1699465732
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
UNICARE COMMUNITY HEALTH CENTER, INC.
Practice address
15863 Kasota Rd
Apple Valley, CA 92307-4507
Phone
(760) 946-1100
Fax
(760) 946-1069
NPI assigned
May 11, 2023
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Kelly Hong Vo
Title
Evp
Phone
(909) 988-2555

Other NPIs on the same Medicare enrollment 20

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

Other NPIs with the same Medicare PAC ID 17

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

Corporate family (same tax ID) 16

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

Practitioners 64

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

View all 64

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2293326Unicare Community Health Center, Inc.15863 Kasota Rd, Apple Valley, CA 92307Certificate of waiverNov 6, 2027

Medicare participation

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

Federally qualified health center certification: CCN A01821

Medicare enrollment files
Legal name
UNICARE COMMUNITY HEALTH CENTER, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 5, 2023
Last certification
Dec 5, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 27, 1999 in CA
Enrollment address
15863 Kasota Rd
Apple Valley, CA 92307-4507

All disclosed owners & managing parties 12

Medicare enrollment files

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

NameRoleSinceShare
Rosio Hobbs Individual Corporate DirectorBoard Secretary Jun 11, 2019
Abraham de Guzman Individual Corporate DirectorBoard Member Dec 4, 2019
Avetik Machkalyan Individual Corporate OfficerCeo Jul 1, 2023
Sergio Martinez Individual Corporate DirectorBoard Member Mar 10, 2020
Alma R Enciso Individual Corporate DirectorBoard Member Mar 8, 2016
Kassandra Sandoval Individual Corporate DirectorBoard Member Aug 10, 2020
Kelly H Vo Individual Corporate OfficerExecutive Vice President Jul 1, 2023
W-2 Managing EmployeeExecutive Vice President Jul 1, 2023
Yadira Contreras Individual Corporate DirectorBoard Member Jul 11, 2018
Nazeli Nercessian Individual Corporate DirectorBoard Member Apr 1, 2017
Vaghinak Vasilyan Individual Corporate DirectorBoard Member Jan 14, 2020
Michael Nolfsinger Individual Corporate DirectorBoard Member Nov 14, 2017
Martha Zuniga Individual Corporate DirectorBoard Chair Dec 5, 2017

Medicare enrollment records 2

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20150623001589 CA Part B Supplier - Clinic/Group Practice 8426369067 Receives reassigned benefits from 141 practitioners
20 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Colton, CA; Apple Valley, CA; San Bernardino, CA; Riverside, CA; Pomona, CA; Pacoima, CA; Ontario, CA; Los Angeles, CA…
O20231207000773 CA Part a Provider - Federally Qualified Health Center (FQHC) 8426369067 Practice locations: Apple Valley, CA

National Provider Directory

National Provider Directory
Tax ID family
Unicare Community Health Center Inc (17 organizations share this tax ID)

Specialties & licenses 1

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

Addresses

NPPES NPI Registry

Primary practice location

15863 Kasota Rd
Apple Valley, CA 92307-4507

Mailing address

437 N Euclid Ave
Ontario, CA 91762-3456
Phone (909) 749-1835

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 13, 2024.

{
    "created_epoch": "1683763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710288000000",
    "number": "1699465732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "437 N EUCLID AVE",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917623456",
            "telephone_number": "909-749-1835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15863 KASOTA RD",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923074507",
            "telephone_number": "760-946-1100",
            "fax_number": "760-946-1069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNICARE COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-11",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A",
        "authorized_official_last_name": "VO",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "HONG",
        "authorized_official_title_or_position": "EVP",
        "authorized_official_telephone_number": "909-988-2555"
    },
    "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 Apple Valley, CA

Sources for this page

Verify at the official NPI Registry.