NPIMap

Organization Active NPI

Community Health Centers of the Central Coast Inc

Doing business as Comm Health Centers Santa Maria II

  • Federally Qualified Health Center (FQHC)
  • Santa Maria, CA
National Provider Identifier
1851417703
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
550000402 Issued in CA
Legal business name
COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST INC
Doing business as
Comm Health Centers Santa Maria II
Practice address
1835 N Broadway
Santa Maria, CA 93454-1404
Phone
(805) 346-2753
Fax
(805) 922-2479
NPI assigned
Mar 22, 2007
Last updated
Dec 12, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

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

Authorized official

Name
Barbara A Allen
Title
Director of Business Office
Phone
(805) 361-8014

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 550000402 CA Primary

Addresses

Primary practice location

1835 N Broadway
Santa Maria, CA 93454-1404

Mailing address

150 Tejas PL
Nipomo, CA 93444-9123
Phone (805) 929-3211

Other identifiers 3

IdentifierTypeStateIssuer
CMM71166FMedicaidCA
ZZZ69714ZOtherCABLUE SHIELD
W150BOtherCAPTAN GROUP #

Other names 1

  • COMM HEALTH CENTERS SANTA MARIA II Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040115001161 CA Part B Supplier - Clinic/Group Practice 7416868120 Receives reassigned benefits from 236 practitioners
27 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Santa Maria, CA; Paso Robles, CA; San Luis Obispo, CA; Templeton, CA; Oceano, CA; Arroyo Grande, CA; Atascadero, CA; Cambria, CA…
O20070810000784 CA Part A Provider - Federally Qualified Health Center (FQHC) 7416868120 Practice locations: Santa Maria, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1851417703. Details of each certification follow.

Federally qualified health center certification: CCN 051108

Legal name
COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST INC
Doing business as
COMMUNITY HEALTH CENTERS BROADWAY
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 8, 2007
Last certification
Oct 8, 2007
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 8, 1978 in CA
Enrollment address
210 N Broadway
Santa Maria, CA 93454-4415

Other NPIs with the same Medicare PAC ID 22

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

View all 22

Other NPIs on the same Medicare enrollment 27

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

View all 27

National Provider Directory

National Provider Directory

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

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
Bertha Campos Individual Corporate DirectorBoard Member Nov 1, 2012
Linda L Costa Individual Corporate OfficerChief Financial Officer Oct 1, 2017 5%
Ronald E Castle Individual Corporate OfficerChief Executive Officer Aug 1, 2007 15%
Corporate Director Aug 7, 2007
Barbara a Allen Individual W-2 Managing EmployeeBusiness Office Manager Aug 7, 2007 5%
Felicity Lazo Individual Corporate DirectorBoard Member Nov 1, 2012 5%
William Gordon Individual Corporate DirectorBoard Member President Nov 1, 2012 5%

Practitioners & affiliated clinicians

Practitioners 5

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": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702339200000",
    "number": "1851417703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 TEJAS PL",
            "city": "NIPOMO",
            "state": "CA",
            "postal_code": "934449123",
            "telephone_number": "805-929-3211",
            "fax_number": "805-929-6440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 N BROADWAY",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934541404",
            "telephone_number": "805-346-2753",
            "fax_number": "805-922-2479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS OFFICE",
        "authorized_official_telephone_number": "805-361-8014"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "550000402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CMM71166F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ69714Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN GROUP #",
            "identifier": "W150B",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COMM HEALTH CENTERS SANTA MARIA II",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "COMM HEALTH CENTERS SANTA MARIA II",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Maria, CA

Sources for this page

Verify at the official NPI Registry.