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SANTA ROSA INDIAN HEALTH CLINIC
NPI 1366028086
Clinic/Center - Federally Qualified Health Center (FQHC) in Mountain Center, CA

Active since March 23, 2021
65175 ST. HIGHWAY 74, MOUNTAIN CENTER, CA 92561(951) 823-8882(951) 225-6879 Get Directions Write a Review

NPPES record last updated: September 16, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 16, 2021, Aug 25, 2021, Mar 23, 2021 (3 updates tracked since 2021).

About Santa Rosa Indian Health Clinic NPPES

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

SANTA ROSA INDIAN HEALTH CLINIC (NPI 1366028086) is a healthcare organization registered as a federally qualified health center (fqhc) in Mountain Center, California and active in the NPI registry since March 2021. The organization lists William Thomsen, Ceo, as its authorized official.

NPPES Registry Identity

NPI1366028086
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameRIVERSIDE-SAN BERNARDINO COUNTY INDIAN HEALTH, INC
Location Address65175 ST. HIGHWAY 74Mountain Center, CA 92561-9231
Mailing Address11980 Mount Vernon AveGrand Terrace, CA 92313-5172 · (909) 864-1097 · Fax (951) 225-6879
Phone(951) 823-8882
Fax(951) 225-6879
Organization SubpartNo
Authorized OfficialWilliam ThomsenCeo · (909) 864-1097
Enumeration DateMarch 23, 2021
Last NPPES UpdateSeptember 16, 20213 updates tracked since enumeration
NPPES CertifiedSeptember 16, 2021
✔ NPI 1366028086 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
65175 ST. HIGHWAY 74, Mountain Center, CA 92561
Open in Google Maps ↗

Other Names 1

Doing Business AsSanta Rosa Indian Health Clinic

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Santa Rosa Indian Health Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

100

Medicare enrollment records show 100 clinicians reassign Medicare billing to Santa Rosa Indian Health Clinic, which bills Medicare for the services they deliver. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 14

Nurse Practitioner32
Family Practice20
Optometry13
Internal Medicine9
Clinical Psychologist5
Obstetrics/Gynecology4
Podiatry4
Pediatric Medicine3
6 other specialties10

Nearest to this location (20)

See all 100
Adam Rife, DPM
Podiatry
NPI 1336600196
39000 BOB HOPE DRIVE, HARRY AND DIANE RINKER BLG
Rancho Mirage, CA 92270
(760) 568-2684
✔ PECOS✔ Accepts Medicare15 mi
Amir Hodge, NP
Nurse Practitioner
NPI 1316938814
68860 PEREZ RD
Cathedral City, CA 92234
(760) 328-4499
✔ PECOS15 mi
Kinji Hawthorne, MD
Internal Medicine
NPI 1023208683
47647 CALEO BAY DR STE 210
La Quinta, CA 92253
(760) 771-1000
✔ PECOS✔ Accepts Medicare16 mi
Alexander Sykora, NP
Nurse Practitioner
NPI 1427556596
50249 HARRISON ST STE K
Coachella, CA 92236
(760) 393-0555
✔ PECOS✔ Accepts Medicare21 mi
Quinten Rowley
Podiatry
NPI 1578525747
23119 SOBOBA WAY
San Jacinto, CA 92583
(951) 654-0803
✔ PECOS✔ Accepts Medicare27 mi
Oluwatoni Arene, MD
Family Practice
NPI 1295051852
23119 SOBOBA RD
San Jacinto, CA 92583
(951) 654-0803
✔ PECOS✔ Accepts Medicare27 mi
Michelle Gutierrez, FNP
Nurse Practitioner
NPI 1558743906
23119 SOBOBA RD
San Jacinto, CA 92583
(951) 654-0803
✔ PECOS✔ Accepts Medicare27 mi
Tracie Noble, NURSE PRACTITIONER
Nurse Practitioner
NPI 1790270544
23119 SOBOBA RD
San Jacinto, CA 92583
(951) 654-0803
✔ PECOS✔ Accepts Medicare27 mi
Nha Han Nguyen, OD
Optometry
NPI 1033782396
23119 SOBOBA RD
San Jacinto, CA 92583
(909) 654-0803
✔ PECOS✔ Accepts Medicare27 mi
Leslie Perez, OD
Optometry
NPI 1942920939
607 DONNA WAY
San Jacinto, CA 92583
(951) 654-0803
✔ PECOS✔ Accepts Medicare28 mi
Brigitte Willis, M.D., PH.D.
Internal Medicine
NPI 1114275930
1627 S HARGRAVE ST
Banning, CA 92220
(951) 922-7852
✔ PECOS✔ Accepts Medicare31 mi
Herbert Mcmichael, PHD
Clinical Psychologist
NPI 1699870006
11555 1/2 POTRERO RD MORONGO INDIAN RESERVATION
Banning, CA 92220
(800) 732-8805
✔ PECOS✔ Accepts Medicare32 mi
Shellee Lazar, M.D.
Obstetrics/Gynecology
NPI 1093806382
350 TERRACINA BLVD
Redlands, CA 92373
(909) 335-5616
✔ PECOS✔ Accepts Medicare51 mi
Julie Wareham, MD
Psychiatry
NPI 1801853114
1809 W REDLANDS BLVD
Redlands, CA 92373
(909) 335-3026
✔ PECOS✔ Accepts Medicare52 mi
Donald Hamby, D.O.
Physical Medicine and Rehabilitation
NPI 1750726485
11980 MOUNT VERNON AVE
Grand Terrace, CA 92313
(909) 864-1097
✔ PECOS✔ Accepts Medicare56 mi
Tana Szoyka
Mental Health Counselor
NPI 1871369355
RIVERISDE SAN BERNARDINO COUNTY INDIAN HEALTH, INC 11980 MOUNT VERNON AVENUE
Grand Terrace, CA 92313
(909) 864-1097
✔ PECOS58 mi
James Tomas, MD
Nephrology
NPI 1902040819
401 E HIGHLAND AVE SUITE 551
San Bernardino, CA 92404
(909) 882-9150
✔ PECOS✔ Accepts Medicare58 mi
Sofronio Basical, MD
Pediatric Medicine
NPI 1508933425
10800 MAGNOLIA AVE
Riverside, CA 92505
(909) 353-2000
✔ PECOS59 mi
Aidan Clarke, MD
Pain Management
NPI 1215941158
1725 W MONTECITO WAY
San Diego, CA 92103
(619) 210-9291
✔ PECOS68 mi
William Kurban, MD
Endocrinology
NPI 1134385271
210 S GRAND AVE STE 224
Glendora, CA 91741
(626) 335-8094
✔ PECOS✔ Accepts Medicare87 mi
See all 100 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 Riverside-San Bernardino County Indian Health, Inc's NPI number?

The NPI number for Riverside-San Bernardino County Indian Health, Inc is 1366028086. It was assigned to this organization in the NPPES registry on March 23, 2021. The provider is doing business as Santa Rosa Indian Health Clinic.

Where is Riverside-San Bernardino County Indian Health, Inc located?

Riverside-San Bernardino County Indian Health, Inc is located at 65175 St. Highway 74, Mountain Center, CA 92561. The listed phone number is (951) 823-8882.

What is Riverside-San Bernardino County Indian Health, 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 Riverside-San Bernardino County Indian Health, Inc enrolled in Medicare?

Yes. Riverside-San Bernardino County Indian Health, Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Riverside-San Bernardino County Indian Health, Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 100 clinicians in 14 Medicare specialties reassign their Medicare billing to Riverside-San Bernardino County Indian Health, 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 Nurse Practitioner (32), Family Practice (20) and Optometry (13). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Riverside-San Bernardino County Indian Health, Inc was last updated on September 16, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.