NPIMap

Organization Active NPI

Lumira Healthcare

Doing business as Modesto Health Center

  • Federally Qualified Health Center (FQHC)
  • Modesto, CA
National Provider Identifier
1760191811
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LUMIRA HEALTHCARE
Doing business as
Modesto Health Center
Modesto Orangeburg Ave Center
Practice address
2116 E. Orangeburg Ave.
Modesto, CA 95355-3370
Phone
(209) 850-3500
Fax
(209) 850-3499
NPI assigned
Nov 17, 2022
Last updated
Sep 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Authorized official

Name
Leslie Abasta-Cummings
Title
Ceo
Phone
(209) 850-3500

Specialties & licenses 1

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

Addresses

Primary practice location

2116 E. Orangeburg Ave.
Modesto, CA 95355-3370

Mailing address

600 B St BLDG a-C
Livingston, CA 95334-9593
Phone (209) 850-3500

Other names 2

  • Modesto Health Center Doing business as
  • Modesto Orangeburg Ave Center Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040426000617 CA Part B Supplier - Clinic/Group Practice 8820084692 Receives reassigned benefits from 81 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Delhi, CA; Hilmar, CA; Hughson, CA; Livingston, CA; Modesto, CA; Patterson, CA; Waterford, CA
O20230123001901 CA Part A Provider - Federally Qualified Health Center (FQHC) 8820084692 Practice locations: Modesto, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1760191811. Details of each certification follow.

Federally qualified health center certification: CCN 921098

Legal name
LIVINGSTON COMMUNITY HEALTH
Doing business as
MODESTO HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 9, 2023
Last certification
May 9, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 3, 1970 in CA
Enrollment address
2116 E Orangeburg Ave
Modesto, CA 95355-3370

Other NPIs with the same Medicare PAC ID 9

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

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Tax ID family
Livingston Community Health Services10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

2116 E Orangeburg Ave
Modesto, CA 95355
Phone (209) 529-1709

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
William Reichle Individual Corporate DirectorBoard Member Jan 1, 2023
Jyotti Pannu Individual Corporate DirectorBoard Member May 1, 2019
Glen Villanueva Individual Corporate OfficerChief Medical Officer Nov 1, 2017
W-2 Managing EmployeeCmo Nov 1, 2017
Mary Conchola Individual Corporate DirectorBoard Member Jun 1, 2014
Hilda Pimentel Individual Corporate DirectorBoard Member Jan 1, 2023
Leslie Abasta-Cummings Individual Corporate OfficerCeo Mar 12, 2012
W-2 Managing EmployeeCeo Mar 12, 2012
Operational/Managerial ControlCeo Mar 12, 2012
Eva Delong Individual Corporate DirectorBoard Secretary Feb 1, 2014
Emily Fleischmann Individual Corporate DirectorBoard Member Jan 1, 2023
Rosalinda Ruiz Individual Corporate DirectorBoard Treasurer Jan 1, 2016
Sandra Schiber Individual Corporate DirectorBoard Member Apr 1, 2022
Mark Hendrickson Individual Corporate DirectorBoard Member Dec 1, 2020
Travis Lake Individual Corporate DirectorBoard Chair Dec 1, 2015

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 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1668643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788307200000",
    "number": "1760191811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 B ST BLDG A-C",
            "city": "LIVINGSTON",
            "state": "CA",
            "postal_code": "953349593",
            "telephone_number": "209-850-3500",
            "fax_number": "209-850-3499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 E. ORANGEBURG AVE.",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953553370",
            "telephone_number": "209-850-3500",
            "fax_number": "209-850-3499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMIRA HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-17",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A",
        "authorized_official_last_name": "ABASTA-CUMMINGS",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "209-850-3500"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Modesto Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Modesto Orangeburg Ave Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.