NPIMap

Organization Active NPI

Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Ocean Shores, WA
National Provider Identifier
1982768248
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
600537278 Issued in WA
Legal business name
SEA MAR COMMUNITY HEALTH CENTERS
Practice address
597 Point Brown Ave NW
Ocean Shores, WA 98569-9632
Phone
(360) 289-2427
Fax
(360) 283-9982
NPI assigned
Dec 21, 2006
Last updated
Feb 26, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Authorized official

Name
Mary E Bartolo
Title
Executive Vice President
Phone
(206) 763-5277

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 600537278 WA Primary
Nurse Practitioner 363L00000X
Family Nurse Practitioner 363LF0000X

Addresses

Primary practice location

597 Point Brown Ave NW
Ocean Shores, WA 98569-9632

Mailing address

PO Box 34703
Seattle, WA 98124-1703

Other identifiers 2

IdentifierTypeStateIssuer
7139694MedicaidWA
2000115MedicaidWA

Other names 2

  • Sea-Mar Community Health Center Former legal business name
  • Sea Mar CHC Ocean Shores Medical Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040211001210 WA Part B Supplier - Clinic/Group Practice 7315831161 Receives reassigned benefits from 551 practitioners
41 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mount Vernon, WA; Ocean Shores, WA; Olympia, WA; Puyallup, WA; Seattle, WA; Spanaway, WA; Everett, WA; Tacoma, WA…
O20070712000864 WA Part A Provider - Federally Qualified Health Center (FQHC) 7315831161 Practice locations: Ocean Shores, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1982768248. Details of each certification follow.

Federally qualified health center certification: CCN 501907

Legal name
SEA MAR COMMUNITY HEALTH CENTERS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 13, 2007
Last certification
Sep 13, 2007
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Dec 11, 2006 in WA
Enrollment address
597 Point Brown Ave NW
Ocean Shores, WA 98569-9632

Other NPIs on the same Medicare enrollment 41

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

View all 41

National Provider Directory

National Provider Directory
Tax ID family
Sea Mar Marysville Medi279 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 18

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

View all 18

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Juan Enrique Garza Individual Corporate Director Aug 6, 2024 9%
Daniela Diaz de la Vega Gonzales Individual Corporate Director Jun 6, 2023 9%
Mary Bartolo Individual Corporate OfficerExecutive Vice President Mar 1, 1988
Corporate DirectorExecutive Vice President Mar 1, 1988
Operational/Managerial ControlExecutive Vice President Mar 1, 1988
Agustin Delgado Individual Corporate Director Mar 13, 2013 9%
Kristina Kathleen Hoeschen Individual Corporate OfficerChief Compliance Officer May 1, 2017
Ricardo Gasca Individual Corporate Director Apr 10, 2010 9%
Gregory J Ma Individual Corporate Director Sep 1, 1982 9%
Bertha Michelle Danley Individual Corporate Director Nov 2, 2001 9%
Felipe Trinidad-Martinez Individual Corporate Director Mar 10, 2004 9%
Erasmo Gamboa Individual Corporate Director Apr 10, 2010 9%
Rogelio Riojas Individual Corporate OfficerCeo Jun 1, 1978
Operational/Managerial ControlChief Executive Officer Jun 1, 1978
Silverio Vivanco-Sanchez Individual Corporate Director May 1, 2008 9%
Jesus R Sanchez Individual Corporate Director Feb 4, 2025 9%

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Sea Mar CHC-Vashon IslandVashon, WA, CCN 941082 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 19, 1978
Sea Mar Community Health CentersSpanaway, WA, CCN 941095 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 19, 1978

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": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740528000000",
    "number": "1982768248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34703",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "597 POINT BROWN AVE NW",
            "city": "OCEAN SHORES",
            "state": "WA",
            "postal_code": "985699632",
            "telephone_number": "360-289-2427",
            "fax_number": "360-283-9982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEA MAR COMMUNITY HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A",
        "authorized_official_last_name": "BARTOLO",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "206-763-5277"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "WA",
            "license": "600537278",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7139694",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2000115",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sea-Mar Community Health Center",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Sea Mar CHC Ocean Shores Medical",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ocean Shores, WA

Sources for this page

Verify at the official NPI Registry.