NPIMap

Organization Active NPI

Bay Area Community Health

Doing business as BACH Family Clinic

  • Federally Qualified Health Center (FQHC)
  • San Jose, CA
National Provider Identifier
1962024059
Registry record updated May 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
BAY AREA COMMUNITY HEALTH
Doing business as
BACH Family Clinic
Practice address
1066 S White Rd Ste 170
San Jose, CA 95127-3812
Phone
(408) 729-9700
NPI assigned
May 12, 2020
Last updated
May 7, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
BAY AREA COMMUNITY HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 7, 2021

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

Authorized official

Name
Jagat Sheth
Title
Chief Financial Officer
Phone
(510) 252-6810

Specialties & licenses 1

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

Addresses

Primary practice location

1066 S White Rd Ste 170
San Jose, CA 95127-3812

Mailing address

40910 Fremont Blvd
Fremont, CA 94538-4375
Phone (510) 770-8040

Other names 1

  • BACH Family Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210312002249 CA Part A Provider - Federally Qualified Health Center (FQHC) 1658349824 Practice locations: San Jose, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962024059. Details of each certification follow.

Federally qualified health center certification: CCN 751182

Legal name
BAY AREA COMMUNITY HEALTH
Doing business as
BACH FAMILY CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 30, 2015
Last certification
Oct 30, 2015
Ownership / control type
Non-profit – church related
Most recent change of ownership
Jun 1, 2020 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Apr 18, 1990 in CA
Enrollment address
1066 S White Rd
Ste 170
San Jose, CA 95127-3812

Other NPIs with the same Medicare PAC ID 10

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

National Provider Directory

National Provider Directory
Tax ID family
Tri City Family Plannin32 organizations share this tax ID, including this one
Part of
Tri City Family Plannin

Other organizations with this tax ID 31

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

View all 31

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
David E Perez Individual Corporate DirectorBoard Member Jan 28, 2018
Bay Area Community Health Organization, Fremont, CA Non-profit 5% Or Greater Direct Ownership Interest Jun 1, 2020 100%
Operational/Managerial Control Nov 15, 2018 100%
Jagat Sheth Individual Corporate OfficerCfo Nov 15, 2018
W-2 Managing EmployeeCfo Nov 15, 2018
Operational/Managerial ControlCeo Nov 15, 2018
Marvin L Wong Individual Corporate DirectorBoard Member Aug 27, 2018
Kobin Lee Individual Corporate OfficerVice Chair / Board Member Nov 15, 2019
Corporate DirectorVice Chair / Board Member Nov 15, 2019
Jacqueline B Belser Individual Corporate OfficerSecretary/Board Member Nov 15, 2018
Corporate DirectorSecretary/Board Member Nov 15, 2018
Yueqin Feng Individual Corporate DirectorBoard Member Nov 15, 2018
Zettie D Page Individual Corporate OfficerCeo Nov 15, 2018 90%
W-2 Managing EmployeeCeo Nov 15, 2018 90%
Operational/Managerial ControlCeo Nov 15, 2018 90%
Sherland D Headley Individual Corporate DirectorBoard Member Nov 15, 2018
Xianzhong Zhu Individual Corporate OfficerTreasurer/Board Member Nov 15, 2018
Corporate DirectorTreasurer/Board Member Nov 15, 2018
Brenda L Quillin Individual Corporate DirectorBoard Member Nov 15, 2016
Stephanie J Reddell Individual Corporate DirectorBoard Member Nov 15, 2018
Najia Hamid Individual Corporate DirectorBoard Member Nov 15, 2018
Robert J Wyckoff Individual Corporate OfficerBoard Chair/Board Member Nov 15, 2018
Corporate DirectorBoard Chair/Board Member Nov 15, 2018

Owners & managing parties with NPI records 10

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

  • Bay Area Community Health

    dba Mowry I

    • Federally Qualified Health Center (FQHC)
    • Fremont, CA
    • NPI 1033296272

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Bay Area Community Health

    dba Aborn Dental Clinic

    • Federally Qualified Health Center (FQHC)
    • Fremont, CA
    • NPI 1184791998

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Bay Area Community Health

    dba Bay Area Community Health Irvington Dave Clinic II

    • Federally Qualified Health Center (FQHC)
    • Fremont, CA
    • NPI 1245719129

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Bay Area Community Health

    dba Bay Area Community Health - Main Street Village

    • Federally Qualified Health Center (FQHC)
    • Fremont, CA
    • NPI 1497021109

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Bay Area Community Health

    dba Monterey Plaza Health Clinic

    • Federally Qualified Health Center (FQHC)
    • San Jose, CA
    • NPI 1598387680

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Bay Area Community Health

    dba Mt. Pleasant Health Center

    • Federally Qualified Health Center (FQHC)
    • San Jose, CA
    • NPI 1659993699

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Bay Area Community Health

    dba McKee Health Clinic

    • Federally Qualified Health Center (FQHC)
    • San Jose, CA
    • NPI 1679381107

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Bay Area Community Health

    dba BACH School Mobile Health Clinic II

    • Federally Qualified Health Center (FQHC)
    • Fremont, CA
    • NPI 1780054379

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Bay Area Community Health

    dba Bay Area Community Health Center Of Gilroy

    • Federally Qualified Health Center (FQHC)
    • Gilroy, CA
    • NPI 1871115964

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Bay Area Community Health

    dba Bay Area Community Health - Hope Project

    • Federally Qualified Health Center (FQHC)
    • Fremont, CA
    • NPI 1942387188

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Gilroy Health ClinicGilroy, CA, CCN 751868 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2020
Monterey Plaza Health ClinicSan Jose, CA, CCN 751869 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2020
Mt. Pleasant School Based ClinicSan Jose, CA, CCN 751867 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2020

Owned or controlled facilities with NPI records 3

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

Facilities with the same owner 3

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

Change-of-ownership history 1

DateEventCounterparty
Jun 1, 2020 Change of OwnershipThis provider was the buyer Foothill Health Center IncCCN 751182, CA, NPI 1538508015

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

NPI Registry JSON

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

{
    "created_epoch": "1589241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620345600000",
    "number": "1962024059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40910 FREMONT BLVD",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945384375",
            "telephone_number": "510-770-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1066 S WHITE RD STE 170",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951273812",
            "telephone_number": "408-729-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY AREA COMMUNITY HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAY AREA COMMUNITY HEALTH",
        "enumeration_date": "2020-05-12",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A",
        "authorized_official_last_name": "SHETH",
        "authorized_official_first_name": "JAGAT",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "510-252-6810"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BACH Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.