NPIMap

Organization Active NPI

Via Care Community Health Center

Doing business as Via Care 607

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
National Provider Identifier
1770034530
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
VIA CARE COMMUNITY HEALTH CENTER
Doing business as
Via Care 607
Practice address
607 S Atlantic Blvd
Los Angeles, CA 90022
Phone
(323) 268-9191
Fax
(323) 268-9119
NPI assigned
Oct 17, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Authorized official

Name
Mrs. Deborah Villar
Title
Chief Executive Officer
Phone
(323) 268-9191

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

607 S Atlantic Blvd
Los Angeles, CA 90022

Mailing address

607 S Atlantic Blvd
Los Angeles, CA 90022-3211
Phone (323) 268-9191

Other names 1

  • Via Care 607 Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20130618000414 CA Part B Supplier - Clinic/Group Practice 1052550365 Receives reassigned benefits from 48 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Los Angeles, CA; South Gate, CA; East Los Angeles, CA; Bellflower, CA
O20210331002344 CA Part A Provider - Federally Qualified Health Center (FQHC) 1052550365 Practice locations: Los Angeles, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1770034530. Details of each certification follow.

Federally qualified health center certification: CCN 921919

Legal name
VIA CARE COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 31, 2021
Last certification
Mar 31, 2021
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 21, 2015 in CA
Enrollment address
607 S Atlantic Blvd
Los Angeles, CA 90022-3211

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Via Care Community Health Center-Elac Student Health Center25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

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

View all 24

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Jose Andrade Individual Corporate DirectorVice Co- Chair Jan 1, 2014
Via Care Community Health Center Organization, Los Angeles, CA Non-profit 5% Or Greater Direct Ownership Interest Oct 21, 2015 100%
Deborah Villar Perez Individual Corporate OfficerChief Executive Officer Apr 26, 2015
Other Apr 26, 2015
Nina Falcetti Individual W-2 Managing EmployeeChief of Human Resources Apr 26, 2015
John Donner Individual Corporate DirectorBoard Chair Jan 1, 2015
Beatrice Bojorquez Individual Corporate DirectorBoard Secretary Jan 1, 2014

Owners & managing parties with NPI records 4

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Via Care Community Health CenterLos Angeles, CA, CCN 751121 Federally qualified health center Operational/Managerial Control (100%) Oct 12, 2010
Via Care Community Health CenterLos Angeles, CA, CCN 921917 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 21, 2015

Owned or controlled facilities with NPI records 2

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

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

Practitioners 11

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": "1476662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646179200000",
    "number": "1770034530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 S ATLANTIC BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900223211",
            "telephone_number": "323-268-9191",
            "fax_number": "323-268-9119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 S ATLANTIC BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90022",
            "telephone_number": "323-268-9191",
            "fax_number": "323-268-9119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIA CARE COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-17",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A",
        "authorized_official_last_name": "VILLAR",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "323-268-9191",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "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": "Via Care 607",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.