NPIMap

Organization Active NPI

Apla Health & Wellness

Doing business as APLA Health & Wellness - Long Beach Center

  • Federally Qualified Health Center (FQHC)
  • Long Beach, CA
National Provider Identifier
1811367709
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
APLA HEALTH & WELLNESS
Doing business as
APLA Health & Wellness - Long Beach Center
Practice address
1043 Elm Ave Ste 302
Long Beach, CA 90813-3295
Phone
(213) 201-1600
NPI assigned
Oct 5, 2015
Last updated
Jan 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Authorized official

Name
Mr. Craig E Thompson
Title
Chief Executive Officer
Phone
(213) 201-1456

Specialties & licenses 1

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

Addresses

Primary practice location

1043 Elm Ave Ste 302
Long Beach, CA 90813-3295

Mailing address

611 S Kingsley Dr
Los Angeles, CA 90005-2319
Phone (213) 201-1600

Other names 1

  • APLA Health & Wellness - Long Beach 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
O20160420000343 CA Part B Supplier - Clinic/Group Practice 4385875236 Receives reassigned benefits from 3 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Los Angeles, CA; Long Beach, CA; West Hollywood, CA
O20161122002294 CA Part A Provider - Federally Qualified Health Center (FQHC) 4385875236 Practice locations: Long Beach, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1811367709. Details of each certification follow.

Federally qualified health center certification: CCN 751934

Legal name
APLA HEALTH & WELLNESS
Doing business as
APLA HEALTH & WELLNESS - LONG BEACH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 18, 2016
Last certification
Apr 18, 2016
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Sep 16, 2004 in CA
Enrollment address
1043 Elm Ave
Ste 302
Long Beach, CA 90813-3295

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory
Tax ID family
Apla Health Wellness12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Ownership & related parties

All disclosed owners & managing parties 21

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

NameRoleSinceShare
Peter Perkowski Individual Corporate DirectorBoard - Chair Oct 22, 2013
Lee Klosinski Individual Corporate DirectorBoard - Vice Chair Oct 22, 2013
Jessie McGrath Individual Corporate DirectorBoard - Secretary Jan 27, 2017
Cody Sisco Individual Corporate DirectorBoard Member Jun 26, 2019
Christopher Tang Individual Corporate DirectorBoard Member Jun 30, 2021
John Squatritto Individual Corporate DirectorBoard Member Jun 26, 2019
Craig E Thompson Individual Corporate OfficerChief Executive Officer Jan 6, 1997
Alan R Walden Individual Corporate DirectorBoard - Treasurer Jan 27, 2017
Jay E Gladstein Individual W-2 Managing EmployeeChief Medical Officer Dec 1, 2017
Steven J Vitero Individual W-2 Managing EmployeeDental Director Jul 7, 2004
Chad Franks Individual Corporate DirectorBoard Member Jun 29, 2019
Robyn L Goldman Individual Corporate OfficerChief Financial Officer Aug 9, 2010
James Patton Individual Corporate DirectorBoard Member Oct 28, 2015
Maricela de Rivera Individual Corporate DirectorBoard Member Jun 30, 2021
Mark Kadzielski Individual Corporate DirectorBoard Member Jun 29, 2019
Lindsey Morrison Individual Corporate Director Jun 30, 2021
Anthony Henderson Individual Corporate DirectorBoard Member Jan 27, 2017
John Sealy Individual Corporate DirectorBoard Member Jun 26, 2019
Natalia Ramos Individual Corporate DirectorBoard Member Jun 26, 2019
M'Alyssa Mecenas Individual Corporate DirectorBoard Member Jun 24, 2020
Paula M Cannon Individual Corporate DirectorBoard Member Oct 25, 2017

Owners & managing parties with NPI records 2

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
Apla Health & Wellness - David Geffen CenterLos Angeles, CA, CCN 751061 Federally qualified health center Other (100%) Oct 9, 2012
Apla Health - Olympic #310Los Angeles, CA, CCN 921032 Federally qualified health center Other Oct 22, 2013

Owned or controlled facilities with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1444003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706486400000",
    "number": "1811367709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 S KINGSLEY DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900052319",
            "telephone_number": "213-201-1600",
            "fax_number": "213-201-1595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1043 ELM AVE STE 302",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133295",
            "telephone_number": "213-201-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APLA HEALTH & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-05",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "213-201-1456",
        "authorized_official_name_prefix": "Mr."
    },
    "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": "APLA Health & Wellness - Long Beach Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.