NPIMap

Organization Active NPI

Camarena Health

  • Federally Qualified Health Center (FQHC)
  • Madera, CA
National Provider Identifier
1902185630
Registry record updated Apr 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
550001827 Issued in CA
Legal business name
CAMARENA HEALTH
Practice address
505 E Almond Avenue,
Suite 101
Madera, CA 93637-5742
Phone
(559) 664-4000
Fax
(559) 675-5625
NPI assigned
Aug 11, 2011
Last updated
Apr 30, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2015

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

Authorized official

Name
Mr. Paulo A Soares
Title
Chief Executive Officer
Phone
(559) 664-4000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X CA
Federally Qualified Health Center (FQHC) 261QF0400X 550001827 CA Primary

Addresses

Primary practice location

505 E Almond Avenue,
Suite 101
Madera, CA 93637-5742

Mailing address

PO Box 299
Madera, CA 93639-0299
Phone (559) 664-4000

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040318000523 CA Part B Supplier - Clinic/Group Practice 4880584317 Receives reassigned benefits from 178 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Oakhurst, CA; Madera, CA; Fresno, CA; Coarsegold, CA; Chowchilla, CA
O20120605000248 CA Part A Provider - Federally Qualified Health Center (FQHC) 4880584317 Practice locations: Madera, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902185630. Details of each certification follow.

Federally qualified health center certification: CCN 551132

Legal name
CAMARENA HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 5, 2012
Last certification
Jun 5, 2012
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Jul 21, 1978 in CA
Enrollment address
505 E Almond Ave
Ste 101
Madera, CA 93637-5745

Other NPIs with the same Medicare PAC ID 23

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

View all 23

Other NPIs on the same Medicare enrollment 16

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

View all 16

National Provider Directory

National Provider Directory
Tax ID family
Darin M Camarena Health25 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 10

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

NameRoleSinceShare
Martha Cardona Individual Corporate DirectorBoard Member May 23, 2018
Joel F Ramirez Individual Corporate OfficerChief Medical Officer Dec 1, 2018
Edgar Jimenez Individual Corporate DirectorBoard Member Jul 26, 2013
Paulo a Soares Individual Corporate OfficerChief Excutive Officer Jan 3, 2012
Monic Asenjo-Wilhite Individual Corporate DirectorBoard Member Jan 3, 2012
Seann Garcia Individual Corporate DirectorBoard Member Jan 3, 2012
Abimael Vargas Individual Corporate DirectorBoard Member Jan 3, 2012
Christine N Howland Individual Corporate OfficerCoo Jan 3, 2012
W-2 Managing EmployeeChief of Operations Jan 3, 2012
Raquel Rodarte Individual Corporate DirectorBoard Member Jan 1, 2015
Cecilia Massetti Individual Corporate DirectorBoard Member Jan 3, 2012

Owners & managing parties with NPI records 1

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

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": "1313020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430352000000",
    "number": "1902185630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 299",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936390299",
            "telephone_number": "559-664-4000",
            "fax_number": "559-675-5625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 E ALMOND AVENUE,",
            "address_2": "SUITE 101",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936375742",
            "telephone_number": "559-664-4000",
            "fax_number": "559-675-5625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMARENA HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-11",
        "last_updated": "2015-04-30",
        "status": "A",
        "authorized_official_last_name": "SOARES",
        "authorized_official_first_name": "PAULO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "559-664-4000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "550001827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madera, CA

Sources for this page

Verify at the official NPI Registry.