SAN YSIDRO HEALTH MOUNTAIN HEALTH FAMILY MEDICINE
NPI 1174164719
Clinic/Center - Federally Qualified Health Center (FQHC) in Campo, CA
About San Ysidro Health Mountain Health Family Medicine NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SAN YSIDRO HEALTH MOUNTAIN HEALTH FAMILY MEDICINE (NPI 1174164719) is a healthcare organization registered as a federally qualified health center (fqhc) in Campo, California and active in the NPI registry since October 2019. The organization lists Kevin Mattson, President/ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
San Ysidro Health Mountain Health Family Medicine is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
576Medicare enrollment records show 576 clinicians reassign Medicare billing to San Ysidro Health Mountain Health Family Medicine, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 5 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 36
Nearest to this location (20)
See all 576Source: 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 Centro De Salud De La Comunidad De San Ysidro, Inc.'s NPI number?
The NPI number for Centro De Salud De La Comunidad De San Ysidro, Inc. is 1174164719. It was assigned to this organization in the NPPES registry on October 4, 2019. The provider is doing business as San Ysidro Health Mountain Health Family Medicine.
Where is Centro De Salud De La Comunidad De San Ysidro, Inc. located?
Centro De Salud De La Comunidad De San Ysidro, Inc. is located at 1388 Buckman Springs Rd, Campo, CA 91906. The listed phone number is (619) 662-4100.
What is Centro De Salud De La Comunidad De San Ysidro, Inc.'s specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.
Is Centro De Salud De La Comunidad De San Ysidro, Inc. enrolled in Medicare?
Yes. Centro De Salud De La Comunidad De San Ysidro, Inc. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Centro De Salud De La Comunidad De San Ysidro, Inc.?
According to the CMS Revalidation Reassignment List (October 2026 release), 576 clinicians in 36 Medicare specialties reassign their Medicare billing to Centro De Salud De La Comunidad De San Ysidro, Inc.. 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 Family Practice (151), Internal Medicine (80) and Nurse Practitioner (62). Of these, 3 practice at this address and 5 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 Centro De Salud De La Comunidad De San Ysidro, Inc. was last updated on November 6, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# San Ysidro Health Mountain Health Family Medicine · NPI 1174164719
Federally Qualified Health Center (FQHC) organization in Campo, California. Organization record, active in the CMS NPPES registry since October 4, 2019.
## Identity
- **NPI:** 1174164719 (Entity type: Organization)
- **Enumerated:** October 4, 2019
- **Primary specialty:** Clinic/Center - Federally Qualified Health Center (FQHC) · taxonomy 261QF0400X
- **Legal business name:** Centro De Salud De La Comunidad De San Ysidro, Inc.
- **Organization subpart:** No
- **Authorized official:** Kevin Mattson, PRESIDENT/CEO
## Practice location
- **Address:** 1388 BUCKMAN SPRINGS RD, Campo, CA 91906-2028
- **Phone:** (619) 662-4100
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 576 clinicians in 36 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (151), Internal Medicine (80), Nurse Practitioner (62); 3 practice at this address and 5 within 10 miles; [full list](https://npiprofile.com/npi/1174164719/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 6, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1174164719) · Data from the CMS NPPES public registry.