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Tahoe Forest Hospital District

Organization Active NPI Rural Health Clinic/Center · Truckee, CA

NPI 1760038772 · NPPES record last updated Aug 18, 2026

Key facts

NPI
1760038772
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
TAHOE FOREST HOSPITAL DISTRICT
Practice address
10121 Pine Ave
Truckee, CA 96161-4835
Phone
(530) 587-6011
NPI assigned
Aug 15, 2019
Organization subpart
No

Authorized official

Name
Crystal Felix
Title
Cfo
Phone
(530) 582-6656

Owners & managing parties with NPI records 11

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

Owned or controlled facilities with NPI records 9

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

Other NPIs with the same Medicare PAC ID 11

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

Corporate family (same tax ID) 10

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

Facilities connected through Provider of Services related, parent or unit certification numbers.

Facilities with the same owner 9

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

Practitioners 181

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

View all 181

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Rural health clinic certification: CCN 058724

Legal name
TAHOE FOREST HOSPITAL DISTRICT
Doing business as
TAHOE FOREST MULTISPECIALTY CLINIC - IM/OB
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 19, 2021
Last certification
Oct 19, 2021
Ownership / control type
Non-profit – church related
Organization structure
Government · Non-profit
Enrollment address
10121 Pine Ave
2ND FL
Truckee, CA 96161-4856
Related CCNs
051328

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Tahoe Forest Hospital District
Organization · Truckee, CA 		5% Or Greater Direct Ownership Interest Jun 1, 2007 100%
Jason Dorst
Individual 		Corporate Officer
Chief Information and Innovation		 Sep 1, 2014
Charles Zipkin
Individual 		Corporate Director
Board Member		 Dec 11, 2014
Dale Chamblin
Individual 		Corporate Director
Board Treasurer		 Feb 12, 2013
Alexander Maclennan
Individual 		Corporate Officer
Chief Human Resources Officer		 Jul 24, 2006
Karen Baffone
Individual 		Corporate Officer
Chief Nursing Officer		 Jul 10, 2016
Mary a Brown
Individual 		Corporate Director
Board Member		 Jun 22, 2017
Harry Weis
Individual 		Corporate Officer
Chief Executive Officer		 Dec 7, 2015
W-2 Managing Employee
Chief Executive Officer		 Dec 7, 2015
Crystal Felix
Individual 		Corporate Officer
Chief Financial Officer		 Mar 1, 2004
Alyce Wong
Individual 		Corporate Director
Board Treasurer		 Dec 15, 2016

All facility ownership & control disclosures 9

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

FacilityTypeRoleSince
Incline Village Community Hospital
Incline Village, NV · CCN 291301		 Hospital 5% Or Greater Direct Ownership Interest (100%) Aug 6, 1996
Tahoe Forest Hospital
Truckee, CA · CCN 051328		 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 6, 2013
Tahoe Forest Hospital
Truckee, CA · CCN 05Z328		 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Tahoe Forest Hospital SNF
Truckee, CA · CCN 555231		 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Aug 22, 2012
Aug 22, 2012
Tahoe Forest Home Health Services
Truckee, CA · CCN 057200		 Home health agency 5% Or Greater Direct Ownership Interest Jan 1, 1966
Tahoe Forest Hospice
Truckee, CA · CCN 051732		 Hospice 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Tahoe Forest Multispecialty Clinic Pediatrics/Primary Care
Truckee, CA · CCN 058707		 Rural health clinic Operational/Managerial Control (100%) Feb 1, 2011
Tahoe Forest Multispecialty Clinics-Im/Card
Truckee, CA · CCN 058713		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Aug 28, 2019
Tahoe Forest Multispecialty Clinic-Incline Village
Incline Village, NV · CCN 293992		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jun 1, 2007
Jun 1, 2007

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20210126001001 CA Part a Provider - Rural Health Clinic 0446161335 Practice locations: Truckee, CA

National Provider Directory

Tax ID family
Tahoe Forest Hosp District (11 organizations share this tax ID)

Locations

12313 Soaring Way
Ste 1B
Truckee, CA 96161
Phone (530) 582-6205

10965 SPG LN
Truckee, CA 96161
Phone (530) 587-6011

10956 Donner Pass Rd
Ste 360
Truckee, CA 96161
Phone (530) 581-8864

10710 Donner Pass Rd
Truckee, CA 96161
Phone (530) 582-7488

10985 Spring Ln
Truckee, CA 96161
Phone (530) 414-4862

10875 Pioneer Trl
Truckee, CA 96161
Phone (530) 582-6378

10956 Donner Pass Rd
Ste 330
Truckee, CA 96161
Phone (530) 582-6450

10989 Donner Pass Rd
Truckee, CA 96161
Phone (530) 582-1212

10051 Lake Ave
Ste 3
Truckee, CA 96161
Phone (530) 587-7461

Community Pool
10939 Truckee Way
Truckee, CA 96161
Phone (530) 587-6011

333 Village Blvd
Ste 201
Incline Village, NV 89451
Phone (775) 831-1964

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Yes

Addresses

Primary practice location

10121 Pine Ave
Truckee, CA 96161-4835

Mailing address

10121 Pine Ave
Truckee, CA 96161-4835

Other names

  • Tahoe Forest MSC IM OB RHC Other name

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address tahoe_forest_health_system1522841@DirectA.mercy.net Direct

Other providers in Truckee, CA

All providers in Truckee, CA · Rural Health Clinic/Center in California

Sources for this page

Verify at the official NPI Registry.