NPIMap

Organization Active NPI

El Rio Santa Cruz Neighborhood Health Center, Inc

Doing business as El Rio OB/GYN Associates

  • Federally Qualified Health Center (FQHC)
  • Tucson, AZ
National Provider Identifier
1932490109
Registry record updated Jul 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
OTC3498 Issued in AZ
Legal business name
EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER, INC
Doing business as
El Rio OB/GYN Associates
Practice address
225 W Irvington Rd
Tucson, AZ 85714-3054
Phone
(520) 670-3857
NPI assigned
Apr 22, 2011
Last updated
Jul 20, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 20, 2016

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

Authorized official

Name
Mrs. Nancy Johnson
Title
Ceo
Phone
(520) 309-2012

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X OTC3498 AZ Primary

Addresses

Primary practice location

225 W Irvington Rd
Tucson, AZ 85714-3054

Mailing address

839 W Congress St
Tucson, AZ 85745-2819
Phone (520) 670-3857

Other identifiers 1

IdentifierTypeStateIssuer
947978MedicaidAZ

Other names 1

  • EL RIO OB/GYN ASSOCIATES Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040205000098 AZ Part B Supplier - Clinic/Group Practice 6305739244 Receives reassigned benefits from 474 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tucson, AZ
O20110901000169 AZ Part A Provider - Federally Qualified Health Center (FQHC) 6305739244 Practice locations: Tucson, AZ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1932490109. Details of each certification follow.

Federally qualified health center certification: CCN 031895

Legal name
EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER, INC.
Doing business as
EL RIO OB/GYN ASSOCIATES
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 21, 2011
Last certification
Sep 21, 2011
Ownership / control type
Non-profit – church related
Organization structure
CorporationNon-profit
Incorporated
Mar 5, 1973 in AZ
Enrollment address
225 W Irvington Rd
Tucson, AZ 85714-3054

Other NPIs with the same Medicare PAC ID 16

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

View all 16

Other NPIs on the same Medicare enrollment 10

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

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
03D1038232El Rio Health Center OB/GYN225 W Irvington, Tucson, AZ 85714Certificate of waiverApr 3, 2028

National Provider Directory

National Provider Directory
Tax ID family
El Rio Santa Cruz NHC R59 organizations share this tax ID, including this one
Part of
El Rio Santa Cruz NHC R

Organizations with this tax ID in the same state 16

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 16

Locations

225 W Irvington Rd
Tucson, AZ 85714
Phone (520) 670-3857

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Miguel Rojas Individual Corporate Director Apr 19, 2011
Kirk Saunders Individual Corporate Director Apr 19, 2011
Enrique Serna Individual Corporate Director Apr 19, 2011
Gail Roberts Individual Corporate Director Apr 19, 2011
Annette Gracia Individual W-2 Managing EmployeeController May 1, 2016
Barbara Soehnlen Individual Corporate Director Apr 19, 2011
Nancy Jean Johnson Individual Corporate OfficerCeo Oct 26, 2015
W-2 Managing EmployeeCeo Oct 26, 2015
Stephen Eggen Individual Corporate Director Apr 19, 2011
Douglas J Spegman Individual Corporate OfficerChief Clinical Officer Jun 1, 2016
W-2 Managing EmployeeChief Clinical Officer Jun 1, 2016
El Rio Santa Cruz Neighborhood Health Center, Inc. Organization, Tucson, AZ Non-profit Operational/Managerial Control Mar 31, 2011
Frank Valenzuela Individual Corporate Director Apr 19, 2011
Brian Flagg Individual Corporate Director Apr 19, 2011
Melvin Reisinger Individual Corporate Director Apr 19, 2011
Jody Yarborough Individual Corporate OfficerCfo Oct 23, 2023
W-2 Managing EmployeeCfo Oct 23, 2023

Owners & managing parties with NPI records 17

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

View all 17

All facility ownership & control disclosures 9

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
El Rio Community Health CenterTucson, AZ, CCN 031801 Federally qualified health center Operational/Managerial Control Sep 30, 2010
El Rio Community Health Center-SoutheastTucson, AZ, CCN 031894 Federally qualified health center Operational/Managerial Control Mar 31, 2011
El Pueblo Health CenterTucson, AZ, CCN 031892 Federally qualified health center Operational/Managerial Control Mar 31, 2011
El Rio Northwest Health CenterTucson, AZ, CCN 031899 Federally qualified health center Operational/Managerial Control Mar 31, 2011
El Rio Southwest Health CenterTucson, AZ, CCN 031897 Federally qualified health center Operational/Managerial Control Mar 31, 2011
El Rio Pascua YaquiTucson, AZ, CCN 031917 Federally qualified health center Operational/Managerial Control Oct 1, 1980
Health on BroadwayTucson, AZ, CCN 031945 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2017
El Rio Health CherrybellTucson, AZ, CCN 031984 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Feb 18, 2019
Health on UniversityTucson, AZ, CCN 031987 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Dec 10, 2019

Owned or controlled facilities with NPI records 9

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

Facilities with the same owner 9

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1303430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468972800000",
    "number": "1932490109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "839 W CONGRESS ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452819",
            "telephone_number": "520-670-3857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 W IRVINGTON RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857143054",
            "telephone_number": "520-670-3857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER",
        "enumeration_date": "2011-04-22",
        "last_updated": "2016-07-20",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "520-309-2012",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "AZ",
            "license": "OTC3498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "947978",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EL RIO OB/GYN ASSOCIATES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.