Active NPI
Ole Health
- Federally Qualified Health Center (FQHC)
- Calistoga, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Federally Qualified Health Center (FQHC)
- License
- 550000616
- Legal business name
- OLE HEALTH
- Practice address
- 911 Washington St.
Calistoga, CA 94515 - Phone
- (707) 709-2308
- Fax
- (707) 251-2988
- NPI assigned
- Jan 31, 2008
- Last updated
- Nov 15, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Alicia Hardy
- Title
- Chief Executive Officer
- Phone
- (707) 254-1774
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | 550000616 | CA | Primary |
Addresses
Primary practice location
911 Washington St.
Calistoga, CA 94515
Mailing address
1141 Pear Tree LN Ste 100
Napa, CA 94558-6485
Phone (707) 254-1770
Other names 1
- OLE Health
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040427001735 | CA | Part B Supplier - Clinic/Group Practice | 7315934767 |
Receives reassigned benefits from 134 practitioners 10 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Napa, CA; Saint Helena, CA; Fairfield, CA; Calistoga, CA; American Canyon, CA |
| O20050819000493 | CA | Part A Provider - Federally Qualified Health Center (FQHC) | 7315934767 | Practice locations: Calistoga, CA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1760660831. Details of each certification follow.
Federally qualified health center certification: CCN 051019
- Legal name
- OLE HEALTH
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Aug 24, 2005
- Last certification
- Aug 24, 2005
- Ownership / control type
- For profit – partnership
- Organization structure
- Corporation
- Incorporated
- Oct 19, 1972 in CA
- Enrollment address
- 911 Washington St
Calistoga, CA 94515-1433 - Related CCNs
- 051001
Related certifications (CCN) 1
Facilities connected through Provider of Services related, parent or unit certification numbers.
Other NPIs with the same Medicare PAC ID 12
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba CommuniCare OLE
- Federally Qualified Health Center (FQHC)
- Davis, CA
- NPI 1558366823
7315934767
-
dba CommuniCare OLE
- Federally Qualified Health Center (FQHC)
- Woodland, CA
- NPI 1558469064
7315934767
-
dba CommuniCare OLE
- Federally Qualified Health Center (FQHC)
- West Sacramento, CA
- NPI 1710087515
7315934767
-
dba CommuniCare OLE
- Federally Qualified Health Center (FQHC)
- West Sacramento, CA
- NPI 1881330579
7315934767
Other NPIs on the same Medicare enrollment 10
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Federally Qualified Health Center (FQHC)
- American Canyon, CA
- NPI 1508573379
O20040427001735
National Provider Directory
National Provider Directory- Tax ID family
- Ole Health
Other organizations with this tax ID 21
Organizations that report the same tax identification number in the National Provider Directory.
-
dba CommuniCare OLE
- Adolescent and Children Mental Health Clinic/Center
- Woodland, CA
- NPI 1073006607
-
dba CommuniCare OLE
- Federally Qualified Health Center (FQHC)
- West Sacramento, CA
- NPI 1144687955
-
- Federally Qualified Health Center (FQHC)
- Fairfield, CA
- NPI 1245043165
-
- Federally Qualified Health Center (FQHC)
- Napa, CA
- NPI 1275257826
-
- Federally Qualified Health Center (FQHC)
- Fairfield, CA
- NPI 1316429558
-
dba CommuniCare Family Wellness Center - Unity Building
- Community/Behavioral Health Agency
- Woodland, CA
- NPI 1366091191
-
- Federally Qualified Health Center (FQHC)
- Napa, CA
- NPI 1447687330
-
- Federally Qualified Health Center (FQHC)
- Fairfield, CA
- NPI 1497130280
-
- Federally Qualified Health Center (FQHC)
- American Canyon, CA
- NPI 1508573379
Ownership & related parties
All disclosed owners & managing parties 13
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Peter Richmond | Corporate Director | Dec 31, 2018 | |
| Madeline Hernandez | Corporate Director | Dec 31, 2018 | |
| Deborah Goodin | Corporate Director | Mar 11, 2022 | |
| Exa Johanna Moore | Corporate Director | Dec 31, 2018 | |
| Beatrice Labastida | Corporate Director | Dec 31, 2018 | |
| Arthur Roosa | Corporate Director | Dec 31, 2018 | |
| Patricia McFarland | Corporate Director | Dec 31, 2018 | |
| Monin Martin | Corporate Director | Mar 11, 2022 | |
| Cephas Mugerwa | Corporate Director | Mar 11, 2022 | |
| Andrew Torge | Corporate Officer | Apr 13, 2020 | |
| Bryan Nazario | Corporate Director | Mar 11, 2022 | |
| Rosemarie Bautista Macisaac | Corporate Officer | Jun 5, 2023 | |
| W-2 Managing Employee | Jun 5, 2023 | ||
| Alicia F Hardy | Corporate Officer | Jan 8, 2018 | |
| W-2 Managing Employee | Jan 8, 2018 |
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Ole Health | Federally qualified health center | Operational/Managerial Control (100%) | Sep 14, 2018 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Federally Qualified Health Center (FQHC)
- Fairfield, CA
- NPI 1316429558
Operational/Managerial Control
Practitioners & affiliated clinicians
Practitioners 25
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.
-
- Clinical Social Worker
- Napa, CA
- NPI 1194908475
-
- Physician Assistant
- Woodland, CA
- NPI 1104537968
-
- Clinical Social Worker
- Fairfield, CA
- NPI 1124623236
-
- Registered Dietitian
- Fairfield, CA
- NPI 1811465800
-
- Medical Physician Assistant
- Napa, CA
- NPI 1427474949
-
- Family Medicine Physician
- Vallejo, CA
- NPI 1073085601
-
- Family Medicine Physician
- Fairfield, CA
- NPI 1255481305
-
- Physician Assistant
- Petaluma, CA
- NPI 1043854151
-
- Physician Assistant
- Fairfield, CA
- NPI 1780480764
-
- Pediatrics Physician
- Los Angeles, CA
- NPI 1164517108
-
- Clinical Social Worker
- Napa, CA
- NPI 1851946925
-
- Marriage & Family Therapist
- Woodland, CA
- NPI 1154859601
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201737600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1573776000000",
"number": "1760660831",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1141 PEAR TREE LN STE 100",
"city": "NAPA",
"state": "CA",
"postal_code": "945586485",
"telephone_number": "707-254-1770",
"fax_number": "707-254-1779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "911 WASHINGTON ST.",
"city": "CALISTOGA",
"state": "CA",
"postal_code": "94515",
"telephone_number": "707-709-2308",
"fax_number": "707-251-2988"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OLE HEALTH",
"organizational_subpart": "NO",
"enumeration_date": "2008-01-31",
"last_updated": "2019-11-15",
"status": "A",
"authorized_official_last_name": "HARDY",
"authorized_official_first_name": "ALICIA",
"authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
"authorized_official_telephone_number": "707-254-1774",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "261QF0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
"state": "CA",
"license": "550000616",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "OLE Health",
"code": "4",
"type": "Former Legal Business Name"
}
]
}Other providers in Calistoga, CA
- Donna Mathews, RN
- Vishnu Nandan, DDS, BDS
- Napa County Health and Human Services (Calistoga - Napa County Alcohol and Drug Services)
- Napa County Health and Human Services (Clinic Ole Calistoga - Napa County Alcohol and Drug Services)
- Jean A Neeley, OD
- Chenoa Olson
- John Christian Oneil, M.D.
- Palisades High School
- Erin E. Pedersen
- Del Rae Phoenix-Wilcox, LCSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.