NPIMap

Organization Active NPI

Community Health Center of Pinellas Inc

Doing business as Evara Health

  • Federally Qualified Health Center (FQHC)
  • Pinellas Park, FL
National Provider Identifier
1811975535
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH CENTER OF PINELLAS INC
Doing business as
Evara Health
Practice address
7550 43Rd St N
Pinellas Park, FL 33781-3601
Phone
(727) 544-2284
Fax
(727) 541-7984
NPI assigned
Jan 3, 2006
Last updated
Oct 17, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY HEALTH CENTER OF PINELLAS INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Authorized official

Name
Edward Kucher
Title
Chief Regulatory Officer
Phone
(727) 824-8100

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X
Obstetrics & Gynecology Physician 207V00000X
Pediatrics Physician 208000000X
General Practice Physician 208D00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

7550 43Rd St N
Pinellas Park, FL 33781-3601

Mailing address

PO Box 10549
St Petersburg, FL 33733-0549
Phone (727) 544-2284

Other identifiers 2

IdentifierTypeStateIssuer
029565503MedicaidFL
060638303MedicaidFL

Other names 1

  • Evara Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040131000031 FL Part B Supplier - Clinic/Group Practice 8527961028 Receives reassigned benefits from 135 practitioners
18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Largo, FL; Tarpon Springs, FL; St Petersburg, FL; Saint Petersburg, FL; Pinellas Park, FL; Dunedin, FL; Clearwater, FL
O20060224000512 FL Part A Provider - Federally Qualified Health Center (FQHC) 8527961028 1 other NPI on this enrollment
Practice locations: Pinellas Park, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1811975535. Details of each certification follow.

Federally qualified health center certification: CCN 101983

Legal name
COMMUNITY HEALTH CENTER OF PINELLAS INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 8, 2006
Last certification
Mar 8, 2006
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Nov 14, 1980 in FL
Enrollment address
7550 43Rd Street N
Pinellas Park, FL 33781-3601

Other NPIs with the same Medicare PAC ID 19

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

View all 19

Other NPIs on the same Medicare enrollment 18

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

View all 18

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0935165Evara Health7550 43Rd St N, Pinellas Park, FL 33781Provider-performed microscopyOct 21, 2027

National Provider Directory

National Provider Directory
Part of
Women Children Health

Locations

6450 38th Ave N
Ste 400
St Petersburg, FL 33710
Phone (727) 345-3991

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Joseph Smith Individual Corporate DirectorChair Apr 9, 2012
Elodie Dorso Individual Corporate DirectorCeo Feb 2, 2018
W-2 Managing EmployeeCeo Aug 1, 2014 100%
Operational/Managerial ControlCeo Feb 2, 2018 100%
Alberto Lense Individual Corporate DirectorBoard Member Nov 1, 2013
Cindy McNulty Individual Corporate DirectorVice Chair May 23, 2008
Frances Serrano Lux Individual Corporate DirectorBoard Member Nov 1, 2013
Luke Williams Individual Corporate Director Apr 9, 2012
Edward Kucher Individual Corporate DirectorCoo Mar 16, 2018
W-2 Managing EmployeeCoo Feb 27, 2017

Practitioners & affiliated clinicians

Practitioners 10

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": "1136246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729123200000",
    "number": "1811975535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10549",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337330549",
            "telephone_number": "727-544-2284",
            "fax_number": "727-541-7984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7550 43RD ST N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337813601",
            "telephone_number": "727-544-2284",
            "fax_number": "727-541-7984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTER OF PINELLAS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY HEALTH CENTER OF PINELLAS INC",
        "enumeration_date": "2006-01-03",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A",
        "authorized_official_last_name": "KUCHER",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "CHIEF REGULATORY OFFICER",
        "authorized_official_telephone_number": "727-824-8100"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029565503",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060638303",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evara Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pinellas Park, FL

Sources for this page

Verify at the official NPI Registry.