NPIMap

Organization Active NPI

Unicare Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Moreno Valley, CA
National Provider Identifier
1881151827
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
UNICARE COMMUNITY HEALTH CENTER INC
Practice address
24853 Alessandro Blvd Ste 4
Moreno Valley, CA 92553-6102
Phone
(951) 571-8518
NPI assigned
Feb 26, 2019
Last updated
Mar 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Authorized official

Name
Avetik Machkalyan
Title
Chief Executive Officer
Phone
(909) 988-2555

Specialties & licenses 1

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

Addresses

Primary practice location

24853 Alessandro Blvd Ste 4
Moreno Valley, CA 92553-6102

Mailing address

437 N Euclid Ave
Ontario, CA 91762-3456
Phone (909) 988-2555

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150623001589 CA Part B Supplier - Clinic/Group Practice 8426369067 Receives reassigned benefits from 141 practitioners
20 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Colton, CA; Apple Valley, CA; San Bernardino, CA; Riverside, CA; Pomona, CA; Pacoima, CA; Ontario, CA; Los Angeles, CA…
O20190729001015 CA Part A Provider - Federally Qualified Health Center (FQHC) 8426369067 Practice locations: Moreno Valley, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1881151827. Details of each certification follow.

Federally qualified health center certification: CCN 921176

Legal name
UNICARE COMMUNITY HEALTH CENTER, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 22, 2019
Last certification
Jul 22, 2019
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 27, 1999 in CA
Enrollment address
24853 Alessandro Blvd
Ste 4
Moreno Valley, CA 92553-6102

Other NPIs with the same Medicare PAC ID 17

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

View all 17

Other NPIs on the same Medicare enrollment 20

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

View all 20

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
05D2023894Unicare Community Health Center, Inc24853 Alessandro BLD, Ste 4, Moreno Valley, CA 92553Certificate of waiverMay 3, 2027

National Provider Directory

National Provider Directory
Tax ID family
Unicare Community Health Center Inc18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Rosio Hobbs Individual Corporate DirectorBoard Secretary Jun 11, 2019
Abraham de Guzman Individual Corporate DirectorBoard Member Dec 4, 2019
Avetik Machkalyan Individual Corporate OfficerCeo May 1, 2019
W-2 Managing EmployeeCeo May 1, 2019
Sergio Martinez Individual Corporate DirectorBoard Member Mar 10, 2020
Alma R Enciso Individual Corporate DirectorBoard Treasurer May 1, 2019
Kassandra Sandoval Individual Corporate DirectorBoard Member Aug 10, 2020
Kelly H Vo Individual Corporate OfficerEvp May 1, 2019
W-2 Managing EmployeeEvp May 1, 2019
Yadira Contreras Individual Corporate DirectorBoard Member May 1, 2019
Nazeli Nercessian Individual Corporate DirectorBoard Member May 1, 2019
Vaghinak Vasilyan Individual Corporate DirectorBoard Member Jan 14, 2020
Michael Nolfsinger Individual Corporate DirectorBoard Member May 1, 2019
Martha Zuniga Individual Corporate DirectorBoard Secretary May 1, 2019

Practitioners & affiliated clinicians

Practitioners 6

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": "1551139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710288000000",
    "number": "1881151827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "437 N EUCLID AVE",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917623456",
            "telephone_number": "909-988-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24853 ALESSANDRO BLVD STE 4",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925536102",
            "telephone_number": "951-571-8518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNICARE COMMUNITY HEALTH CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-26",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A",
        "authorized_official_last_name": "MACHKALYAN",
        "authorized_official_first_name": "AVETIK",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "909-988-2555"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

Verify at the official NPI Registry.