ELICA HEALTH CENTERS - MIDTOWN MEDICAL CENTERS
NPI 1093974065
Clinic/Center - Federally Qualified Health Center (FQHC) in Sacramento, CA
About Elica Health Centers - Midtown Medical Centers NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ELICA HEALTH CENTERS - MIDTOWN MEDICAL CENTERS (NPI 1093974065) is a healthcare organization registered as a federally qualified health center (fqhc) in Sacramento, California and active in the NPI registry since June 2008. The organization holds 10 active CLIA laboratory certificates and lists Tatyana Bak, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Elica Health Centers - Midtown Medical Centers is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
90Medicare enrollment records show 90 clinicians reassign Medicare billing to Elica Health Centers - Midtown Medical Centers, which bills Medicare for the services they deliver. Of these, 10 practice at this address and 75 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 13
Nearest to this location (20)
See all 90Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA 10
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 05D2246803
Elica Health Centers Health On Wheels (vin#4uzadfdtoecft9304) · Sacramento, CACertificate of Waiver 05D1093423
Elica Health Centers · Sacramento, CACertificate of Waiver 05D2191792
Elica Health Centers - North Highlands · North Highlands, CACertificate of Waiver 05D2258571
Elica Health Centers- Halyard Medical Center · West Sacramento, CACertificate for Provider-Performed Microscopy Procedures (PPMP) 05D2270998
Elica Health Centers - Glendale · Sacramento, CACertificate of Waiver 05D2246801
Elica Health Centers Health On Wheels - 2 (vin# Ifdnf6dc2da03427) · West Sacramento, CAFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Elica Health Centers's NPI number?
The NPI number for Elica Health Centers is 1093974065. It was assigned to this organization in the NPPES registry on June 5, 2008. The provider is also known as Elica Health Centers - Midtown Medical Centers.
Where is Elica Health Centers located?
Elica Health Centers is located at 3701 J St Ste 201, Sacramento, CA 95816. The listed phone number is (916) 454-2345.
What is Elica Health Centers's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.
Is Elica Health Centers enrolled in Medicare?
Yes. Elica Health Centers is registered in the Medicare PECOS enrollment system.
When is Elica Health Centers's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Part A enrollment for this organization (California, Federally Qualified Health Center (FQHC)) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Elica Health Centers?
According to the CMS Revalidation Reassignment List (October 2026 release), 90 clinicians in 13 Medicare specialties reassign their Medicare billing to Elica Health Centers. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (31), Family Practice (12) and Pediatric Medicine (11). Of these, 10 practice at this address and 75 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Elica Health Centers hold CLIA laboratory certificates?
Yes. 10 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
When was this NPI record last updated?
The NPPES record for Elica Health Centers was last updated on February 18, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Elica Health Centers - Midtown Medical Centers · NPI 1093974065
Federally Qualified Health Center (FQHC) organization in Sacramento, California. Organization record, active in the CMS NPPES registry since June 5, 2008.
## Identity
- **NPI:** 1093974065 (Entity type: Organization)
- **Enumerated:** June 5, 2008
- **Primary specialty:** Clinic/Center - Federally Qualified Health Center (FQHC) · taxonomy 261QF0400X
- **Legal business name:** Elica Health Centers
- **Organization subpart:** Yes (part of Elica Health Centers)
- **Authorized official:** Tatyana Bak, CEO
## Practice location
- **Address:** 3701 J ST STE 201, Sacramento, CA 95816-5542
- **Phone:** (916) 454-2345 · **Fax:** (916) 457-2667
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Part A, California, Federally Qualified Health Center (FQHC)) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 90 clinicians in 13 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (31), Family Practice (12), Pediatric Medicine (11); 10 practice at this address and 75 within 10 miles; [full list](https://npiprofile.com/npi/1093974065/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 18, 2022
- **CLIA laboratory certificates:** 10 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1093974065) · Data from the CMS NPPES public registry.