1. Home
  2. Directory
  3. NPI Profile

EVERGREEN HEALTH CENTER LLC
NPI 1356839575
Clinic/Center - Primary Care in Maite, GU

Active since April 23, 2018CLIA 65D2170458 · Waiver
520 ROUTE 8, MAITE, GU 96910(671) 922-0118(671) 477-2464 Get Directions Write a Review

NPPES record last updated: March 29, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 29, 2020, Dec 27, 2018, Apr 23, 2018 (3 updates tracked since 2018).

About Evergreen Health Center Llc NPPES

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

EVERGREEN HEALTH CENTER LLC (NPI 1356839575) is a healthcare organization registered as a primary care in Maite, Guam and active in the NPI registry since April 2018. The organization holds a CLIA Waiver certificate valid through August 11, 2027 and lists Jayar Calilung, Clinic Manager, as its authorized official.

NPPES Registry Identity

NPI1356839575
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameEVERGREEN HEALTH CENTER LLC
Location Address520 ROUTE 8Maite, GU 96910
Mailing Address520 Route 8Maite, GU 96910 · (671) 922-0118 · Fax (671) 472-3981
Phone(671) 922-0118
Fax(671) 477-2464
Organization SubpartNo
Authorized OfficialJayar CalilungClinic Manager · (671) 488-8817
Enumeration DateApril 23, 2018
Last NPPES UpdateMarch 29, 20203 updates tracked since enumeration
NPPES CertifiedMarch 29, 2020
✔ NPI 1356839575 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Evergreen Health Center Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Evergreen Health Center LLC, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (3)

Frank Farrell, M.D.
Gastroenterology
NPI 1891770905
2186 GEARY BLVD SUITE 320
San Francisco, CA 94115
(415) 749-6900
✔ PECOS✔ Accepts Medicare
Delores Lee, M.D.
Family Practice
NPI 1760826937
655 HARMON LOOP RD STE 108
Dededo, GU 96929
(671) 633-4447
✔ PECOS
Faraz Ouhadi, M.D.
Internal Medicine
NPI 1063517639
633 GOVERNOR CARLOS CAMACHO ROAD SUITE 305
Tamuning, GU 96913
(671) 649-7232
✔ PECOS✔ Accepts Medicare

Source: 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

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 65D2170458

Evergreen Health Center · Agana, GU
Active · expires Aug 11, 2027
CLIA Number65D2170458
Laboratory TypeCommunity Clinic
Certificate Effective DateAugust 12, 2025
Certificate Expiration DateAugust 11, 2027
Laboratory DirectorOuhadi Faraz
Laboratory Phone(671) 922-0118
Laboratory LocationEvergreen Health Center520 Route 8, Agana, GU 96910
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Evergreen Health Center LLC's NPI number?

The NPI number for Evergreen Health Center LLC is 1356839575. It was assigned to this organization in the NPPES registry on April 23, 2018.

Where is Evergreen Health Center LLC located?

Evergreen Health Center LLC is located at 520 Route 8, Maite, GU 96910. The listed phone number is (671) 922-0118.

What is Evergreen Health Center LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Is Evergreen Health Center LLC enrolled in Medicare?

Yes. Evergreen Health Center LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Evergreen Health Center LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Evergreen Health Center LLC, in Family Practice, Gastroenterology and Internal Medicine. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Evergreen Health Center LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 65D2170458) is associated with this NPI, valid through August 11, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Evergreen Health Center LLC was last updated on March 29, 2020. 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.