NPIMap

Organization Active NPI

Marana Health Center, Inc

Doing business as Clinica Del Alma

  • Federally Qualified Health Center (FQHC)
  • Tucson, AZ
National Provider Identifier
1972662294
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MARANA HEALTH CENTER, INC
Doing business as
Clinica Del Alma
Practice address
3690 S Park Ave Ste 805
Tucson, AZ 85713-5042
Phone
(520) 616-6760
Fax
(520) 616-6799
NPI assigned
Dec 6, 2006
Last updated
May 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Authorized official

Name
Joshua B Carzoli, PHARMD
Title
Ceo
Phone
(520) 682-4111

Specialties & licenses 1

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

Addresses

Primary practice location

3690 S Park Ave Ste 805
Tucson, AZ 85713-5042

Mailing address

PO Box 188
Marana, AZ 85653-0188
Phone (520) 616-6760

Other identifiers 1

IdentifierTypeStateIssuer
929554MedicaidAZ

Other names 1

  • Clinica Del Alma Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070203000169 AZ Part A Provider - Federally Qualified Health Center (FQHC) 2365348091 Practice locations: Tucson, AZ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972662294. Details of each certification follow.

Federally qualified health center certification: CCN 031854

Legal name
MARANA HEALTH CENTER INC
Doing business as
CLINICA DEL ALMA
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 23, 2007
Last certification
Mar 23, 2007
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Sep 24, 1957 in AZ
Enrollment address
3690 S Park Ave
Ste 805
Tucson, AZ 85713-5042

Other NPIs with the same Medicare PAC ID 13

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

View all 13

National Provider Directory

National Provider Directory
Tax ID family
Marana Community Clinic42 organizations share this tax ID, including this one

Other organizations with this tax ID 41

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

View all 41

Locations

13396 N Marana Main St
BLDG B
Marana, AZ 85653

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
Edward Sicurello Individual Corporate DirectorOfficer - Vice President Jul 10, 2023
John Decker Individual Corporate DirectorOfficer - President Apr 1, 2017
Celina Stude Individual Corporate DirectorOfficer - Secretary Jun 7, 2020
Joshua Carzoli Individual Corporate OfficerChief Executive Officer Jan 26, 2023 100%
Operational/Managerial ControlChief Executive Officer Jan 26, 2023 100%
Nathan Bolt Individual Corporate DirectorOfficer - Treasurer Sep 18, 2022
Anne Schmotzer Individual Corporate DirectorBoard Member Jan 19, 2023
Charles Steven Sera Individual Corporate DirectorBoard Member Jul 1, 2013
Heidi Kurgat Individual Operational/Managerial ControlDirector of Compliance and Risk Mar 26, 2024
Janice L Truitt Individual Corporate DirectorBoard Member Oct 23, 2017
Tanisha Quenette Green Individual Corporate DirectorDirector - Board Member Apr 3, 2023
Craig Reck Individual Corporate DirectorBoard Member Feb 1, 2021
Charles Feller Lang Individual Corporate DirectorDirector - Board Member Jul 1, 2024

Practitioners & affiliated clinicians

Practitioners 1

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": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714953600000",
    "number": "1972662294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "856530188",
            "telephone_number": "520-616-6760",
            "fax_number": "520-616-6799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3690 S PARK AVE STE 805",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857135042",
            "telephone_number": "520-616-6760",
            "fax_number": "520-616-6799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARANA HEALTH CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A",
        "authorized_official_last_name": "CARZOLI",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "520-682-4111",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "929554",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinica Del Alma",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.