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GRACELIGHT COMMUNITY HEALTH
NPI 1104075282
Clinic/Center - Federally Qualified Health Center (FQHC) in Los Angeles, CA

Active since September 15, 2008
4816 E 3RD ST, LOS ANGELES, CA 90022(323) 780-4510(323) 780-6132 Get Directions Write a Review

NPPES record last updated: October 29, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jun 27, 2024, Jan 26, 2021 (2 updates tracked since 2021).

About Gracelight Community Health NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GRACELIGHT COMMUNITY HEALTH (NPI 1104075282), doing business as Queenscare Health Centers, is a healthcare organization registered as a federally qualified health center (fqhc) in Los Angeles, California and active in the NPI registry since September 2008. The organization lists Eloisa Perard, President And Ceo, as its authorized official.

NPPES Registry Identity

NPI1104075282
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameGRACELIGHT COMMUNITY HEALTH
Location Address4816 E 3RD STLos Angeles, CA 90022-1602
Mailing Address4816 E 3rd StLos Angeles, CA 90022-1602 · (323) 780-4510 · Fax (323) 981-1662
Phone(323) 780-4510
Fax(323) 780-6132
Organization SubpartNo
Authorized OfficialEloisa PerardPresident And Ceo · (323) 669-4321
Enumeration DateSeptember 15, 2008
Last NPPES UpdateOctober 29, 20252 updates tracked since enumeration
NPPES CertifiedOctober 29, 2025
✔ NPI 1104075282 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
4816 E 3RD ST, Los Angeles, CA 90022
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Other Names 1

Former Legal Business NameQueenscare Health Centers

Other Identifiers 3

OtherW6997DCA · Medicare Provider Number
MedicaidCMM70660FCA
Other55-1019CA · Medicare Fqhc Provider Number

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Gracelight Community Health is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

75

Medicare enrollment records show 75 clinicians reassign Medicare billing to Gracelight Community Health, which bills Medicare for the services they deliver. Of these, 7 practice at this address and 46 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 11

Nurse Practitioner16
Obstetrics/Gynecology12
Family Practice11
Pediatric Medicine10
Dentist8
Internal Medicine5
Optometry5
Clinical Social Worker3
3 other specialties5

Nearest to this location (20)

See all 75
Saira Dar, MD
Family Practice
NPI 1366412165
4816 E 3RD ST
Los Angeles, CA 90022
(817) 707-4714
✔ PECOS✔ Accepts MedicareSame address
Goretti Garcia, MD
Family Practice
NPI 1487740619
4816 E 3RD ST
Los Angeles, CA 90022
(323) 780-4510
✔ PECOSSame address
Moe Kyi, M.D.
Internal Medicine
NPI 1487932612
4816 E 3RD ST
Los Angeles, CA 90022
(323) 780-4510
✔ PECOS✔ Accepts MedicareSame address
Annie Ledoux, DDS
Dentist
NPI 1689933178
4816 E 3RD ST
Los Angeles, CA 90022
(323) 780-4510
✔ PECOSSame address
Hla Moe
Internal Medicine
NPI 1811316151
4816 E 3RD ST
Los Angeles, CA 90022
(323) 780-4510
✔ PECOSSame address
Cecilia Mitchell, DDS
Oral Surgery
NPI 1053483339
4816 E 3RD ST
Los Angeles, CA 90022
(323) 780-4510
✔ PECOSSame address
Karla Turner, DDS
Oral Surgery
NPI 1003975566
4816 E 3RD ST
Los Angeles, CA 90022
(323) 780-4510
✔ PECOSSame address
Winnie Tan, D.D.S.
Dentist
NPI 1730229832
2621 E 1ST ST
Los Angeles, CA 90033
(323) 268-9386
✔ PECOS2.7 mi
Adriana Arredondo, FNP
Nurse Practitioner
NPI 1174894208
520 E TEMPLE ST
Los Angeles, CA 90012
(213) 473-6960
✔ PECOS✔ Accepts Medicare4.4 mi
Ben Ha, M.D.,
Obstetrics/Gynecology
NPI 1043305774
711 W COLLEGE ST SUITE 540
Los Angeles, CA 90012
(213) 626-5151
✔ PECOS✔ Accepts Medicare5.2 mi
Jamie Lin, M.D.
Obstetrics/Gynecology
NPI 1588960538
711 W COLLEGE ST SUITE M88
Los Angeles, CA 90012
(213) 626-5151
✔ PECOS5.2 mi
Yecenia Cueva, NURSE PRACTITIONER
Nurse Practitioner
NPI 1184198624
1400 S GRAND AVE STE 800
Los Angeles, CA 90015
(213) 748-1414
✔ PECOS✔ Accepts Medicare6.0 mi
Martha Mateo, LCSW
Clinical Social Worker
NPI 1215584974
1414 S GRAND AVE STE 380
Los Angeles, CA 90015
(213) 743-9000
✔ PECOS6.0 mi
Lizeth Lopez Zamora
Clinical Social Worker
NPI 1023563848
1200 WILSHIRE BLVD SUITE 210
Los Angeles, CA 90017
(213) 481-7464
✔ PECOS✔ Accepts Medicare6.2 mi
Daniel Sanchez, M.D
Family Practice
NPI 1366435190
201 S. ALVARADO STREET SUITE 717
Los Angeles, CA 90057
(213) 989-6959
✔ PECOS✔ Accepts Medicare6.8 mi
Dienan Tran, D.D.S.
Dentist
NPI 1841465721
4448 YORK BLVD
Los Angeles, CA 90041
(323) 344-5233
✔ PECOS7.1 mi
Larry Alenbaugh, O.P.T
Optometry
NPI 1881631885
150 N RENO ST
Los Angeles, CA 90026
(323) 669-4326
✔ PECOS7.4 mi
Moe Aung, M.D.
Internal Medicine
NPI 1427370618
150 N RENO ST
Los Angeles, CA 90026
(213) 380-7298
✔ PECOS✔ Accepts Medicare7.4 mi
Maria Teresa Lim Heya, MD
Pediatric Medicine
NPI 1952348849
150 N RENO ST
Los Angeles, CA 90026
(213) 380-7298
✔ PECOS7.4 mi
Bo Shin, DPM
Podiatry
NPI 1568769149
4618 FOUNTAIN AVE
Los Angeles, CA 90029
(323) 953-7170
✔ PECOS✔ Accepts Medicare8.6 mi
See all 75 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently 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 Gracelight Community Health's NPI number?

The NPI number for Gracelight Community Health is 1104075282. It was assigned to this organization in the NPPES registry on September 15, 2008. The provider was formerly known as QueensCare Health Centers.

Where is Gracelight Community Health located?

Gracelight Community Health is located at 4816 E 3rd St, Los Angeles, CA 90022. The listed phone number is (323) 780-4510.

What is Gracelight Community Health's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Is Gracelight Community Health enrolled in Medicare?

Yes. Gracelight Community Health is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Gracelight Community Health?

According to the CMS Revalidation Reassignment List (October 2026 release), 75 clinicians in 11 Medicare specialties reassign their Medicare billing to Gracelight Community Health. 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 (16), Obstetrics/Gynecology (12) and Family Practice (11). Of these, 7 practice at this address and 46 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Gracelight Community Health was last updated on October 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.