Beverlycare

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

BEVERLYCARE

Practice address

433 N 4TH St Ste 205a
Montebello, CA 90640-4311

Phone

(909) 939-1319

NPI assigned

Nov 19, 2024

Organization subpart

No

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

Authorized official

Name

Angel Hsiao

Title

Ceo Cfo

Phone

(909) 939-1319

Specialties & licenses 2

Addresses

Other names 1

• BeverlyCare Women's Clinic Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

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

• Beverlycare

  • Federally Qualified Health Center (FQHC)
  • Montebello, CA
  • NPI 1760936884

  O20180727002401

  Same enrollment
• Beverlycare

  • Federally Qualified Health Center (FQHC)
  • Montebello, CA
  • NPI 1841836301

  O20180727002401

  Same enrollment

Tax ID family

Beverlycare4 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.

• Beverlycare

  • Federally Qualified Health Center (FQHC)
  • Montebello, CA
  • NPI 1114562287
  NPD tax ID
• Beverlycare

  • Federally Qualified Health Center (FQHC)
  • Montebello, CA
  • NPI 1114867710
  NPD tax ID
• Beverlycare

  • Federally Qualified Health Center (FQHC)
  • Montebello, CA
  • NPI 1760936884
  NPD tax ID

Locations

Practitioners 3

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

• Mosen Michael Defrawy, MD

  • Internal Medicine Physician
  • Montebello, CA
  • NPI 1457409401
  NPD
• Fenny Kuan Lin, NP-C

  • Family Nurse Practitioner
  • Montebello, CA
  • NPI 1609237155
  NPD
• Jaw J Wang, MD

  • Pediatrics Physician
  • Montebello, CA
  • NPI 1336220318
  NPD

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

{
    "created_epoch": "1731974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731974400000",
    "number": "1750106332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 N 4TH ST STE 205A",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906404311",
            "telephone_number": "909-939-1319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 N 4TH ST STE 205A",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906404311",
            "telephone_number": "909-939-1319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEVERLYCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-19",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-18",
        "status": "A",
        "authorized_official_last_name": "HSIAO",
        "authorized_official_first_name": "ANGEL",
        "authorized_official_title_or_position": "CEO CFO",
        "authorized_official_telephone_number": "909-939-1319"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BeverlyCare Women's Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Beverly Plaza RX Inc
• Beverly Professional Pharmacy
• Beverly Urgent Care Inc
• Beverlycare
• Beverlycare
• Beverlycare
• Beverlycare
• Shamik Bhadra, MD
• Roshni Bhakta
• Bhava Narayanan, M.D. a Professional Medical Corporation

• Federally Qualified Health Center (FQHC) in Montebello, CA
• Providers in Montebello, CA by specialty
• Federally Qualified Health Center (FQHC) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.