NPIMap

Organization Active NPI

Tahoe Forest Hospital District

  • Rural Health Clinic/Center
  • Truckee, CA
National Provider Identifier
1760038772
Registry record updated Aug 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 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
Last updated
Aug 18, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2026

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

10121 Pine Ave
Truckee, CA 96161-4835

Mailing address

10121 Pine Ave
Truckee, CA 96161-4835

Other names 1

  • Tahoe Forest MSC IM OB RHC Other name

Electronic endpoints 1

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1760038772. Details of each certification follow.

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
GovernmentNon-profit
Enrollment address
10121 Pine Ave
2ND FL
Truckee, CA 96161-4856
Related CCNs
051328

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

Other NPIs with the same Medicare PAC ID 11

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

National Provider Directory

National Provider Directory
Tax ID family
Tahow Forest Hosp District11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

10175 Levone Ave
Truckee, CA 96161
Phone (530) 582-3277

10956 Donner Pass Rd
Ste 100
Truckee, CA 96161
Phone (530) 587-7607

10956 Donner Pass Rd
Ste 230
Truckee, CA 96161
Phone (530) 582-3277

10956 Donner Pass Rd
Ste 330
Truckee, CA 96161
Phone (530) 548-2830

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

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

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

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

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

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

889 Alder Ave
Ste 303
Incline Vlg, NV 89451
Phone (530) 582-8300

Ownership & related parties

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 OfficerChief Information and Innovation Sep 1, 2014
Charles Zipkin Individual Corporate DirectorBoard Member Dec 11, 2014
Dale Chamblin Individual Corporate DirectorBoard Treasurer Feb 12, 2013
Alexander Maclennan Individual Corporate OfficerChief Human Resources Officer Jul 24, 2006
Karen Baffone Individual Corporate OfficerChief Nursing Officer Jul 10, 2016
Mary a Brown Individual Corporate DirectorBoard Member Jun 22, 2017
Harry Weis Individual Corporate OfficerChief Executive Officer Dec 7, 2015
W-2 Managing EmployeeChief Executive Officer Dec 7, 2015
Crystal Felix Individual Corporate OfficerChief Financial Officer Mar 1, 2004
Alyce Wong Individual Corporate DirectorBoard Treasurer Dec 15, 2016

Owners & managing parties with NPI records 11

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

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 HospitalIncline Village, NV, CCN 291301 Hospital 5% Or Greater Direct Ownership Interest (100%) Aug 6, 1996
Tahoe Forest HospitalTruckee, CA, CCN 051328 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 6, 2013
Tahoe Forest HospitalTruckee, CA, CCN 05Z328 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Tahoe Forest Hospital SNFTruckee, 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 ServicesTruckee, CA, CCN 057200 Home health agency 5% Or Greater Direct Ownership Interest Jan 1, 1966
Tahoe Forest HospiceTruckee, CA, CCN 051732 Hospice 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Tahoe Forest Multispecialty Clinic Pediatrics/Primary CareTruckee, CA, CCN 058707 Rural health clinic Operational/Managerial Control (100%) Feb 1, 2011
Tahoe Forest Multispecialty Clinics-Im/CardTruckee, CA, CCN 058713 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Aug 28, 2019
Tahoe Forest Multispecialty Clinic-Incline VillageIncline Village, NV, CCN 293992 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jun 1, 2007
Jun 1, 2007

Owned or controlled facilities with NPI records 9

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

Facilities with the same owner 9

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

Practitioners & affiliated clinicians

Practitioners 153

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 153

NPI Registry JSON

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

{
    "created_epoch": "1565827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787011200000",
    "number": "1760038772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10121 PINE AVE",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "961614835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10121 PINE AVE",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "961614835",
            "telephone_number": "530-587-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAHOE FOREST HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-15",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A",
        "authorized_official_last_name": "FELIX",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "530-582-6656"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tahoe_forest_health_system1522841@DirectA.mercy.net",
            "affiliation": "N",
            "endpointDescription": "Tahoe Forest Health System Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ccd hl7",
            "address_1": "10121 Pine Ave Fl 2",
            "city": "Truckee",
            "state": "CA",
            "country_code": "US",
            "postal_code": "961614835",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Tahoe Forest MSC IM OB RHC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Truckee, CA

Sources for this page

Verify at the official NPI Registry.