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SAN YSIDRO HEALTH EL CAJON/SAN DIEGO PACE
NPI 1568845741
Clinic/Center - Federally Qualified Health Center (FQHC) in El Cajon, CA

Active since July 07, 2015CLIA 05D2034459 · Waiver
875 EL CAJON BLVD, EL CAJON, CA 92020(619) 662-4100(619) 205-6373 Get Directions Write a Review

NPPES record last updated: December 30, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Dec 30, 2020, Dec 18, 2020, Nov 6, 2018 and 3 more (6 updates tracked since 2016).

About San Ysidro Health El Cajon/san Diego Pace NPPES

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

SAN YSIDRO HEALTH EL CAJON/SAN DIEGO PACE (NPI 1568845741) is a healthcare organization registered as a federally qualified health center (fqhc) in El Cajon, California and active in the NPI registry since July 2015. The organization holds a CLIA Waiver certificate valid through June 23, 2028 and lists Kevin Mattson, President And Ceo, as its authorized official.

NPPES Registry Identity

NPI1568845741
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameCENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO, INC.
Location Address875 EL CAJON BLVDEl Cajon, CA 92020-5714
Mailing Address1601 Precision Park LnSan Diego, CA 92173-1345 · (619) 662-4100
Phone(619) 662-4100
Fax(619) 205-6373
Organization SubpartNo
Authorized OfficialKevin MattsonPresident And Ceo · (619) 662-4100
Enumeration DateJuly 7, 2015
Last NPPES UpdateDecember 30, 20206 updates tracked since enumeration
NPPES CertifiedDecember 30, 2020
✔ NPI 1568845741 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
875 EL CAJON BLVD, El Cajon, CA 92020
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Other Names 1

Doing Business AsSan Ysidro Health El Cajon/san Diego Pace

Other Identifiers 1

OtherW5740CA · Part B Ptan

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 El Cajon/san Diego Pace is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

576

Medicare enrollment records show 576 clinicians reassign Medicare billing to San Ysidro Health El Cajon/San Diego Pace, which bills Medicare for the services they deliver. Of these, 16 practice at this address and 111 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 36

Family Practice151
Internal Medicine80
Nurse Practitioner62
Dentist35
Clinical Social Worker32
Emergency Medicine31
Pediatric Medicine27
Psychiatry26
28 other specialties132

Nearest to this location (20)

See all 576
Alan Awdisho, D.O.
Internal Medicine
NPI 1164795498
875 EL CAJON BLVD
El Cajon, CA 92020
(619) 662-4100
✔ PECOS✔ Accepts MedicareSame address
Tamara Mansy, MD
Internal Medicine
NPI 1396277737
875 EL CAJON BLVD
El Cajon, CA 92020
(619) 662-4100
✔ PECOS✔ Accepts MedicareSame address
Amanda Weaver
Marriage and Family Therapist
NPI 1174266423
875 EL CAJON BLVD
El Cajon, CA 92020
(619) 247-3930
✔ PECOSSame address
Samuel Ani
Internal Medicine
NPI 1215514823
875 EL CAJON BLVD FL 1
El Cajon, CA 92020
(619) 205-4585
✔ PECOSSame address
Ammar Khaleel
Clinical Social Worker
NPI 1841744208
875 EL CAJON BLVD
El Cajon, CA 92020
(619) 662-4100
✔ PECOS✔ Accepts MedicareSame address
Dorreen Danesh, MD
Internal Medicine
NPI 1902432826
875 EL CAJON BLVD
El Cajon, CA 92020
(619) 662-4100
✔ PECOSSame address
Nancy Downey, NP
Nurse Practitioner
NPI 1578051017
875 EL CAJON BLVD
El Cajon, CA 92020
(626) 662-4100
✔ PECOS✔ Accepts MedicareSame address
Catherine Ekladios, MD
Endocrinology
NPI 1467061309
875 EL CAJON BLVD
El Cajon, CA 92020
(619) 662-4100
✔ PECOS✔ Accepts MedicareSame address
Nour Elgezawi, ACSW
Clinical Social Worker
NPI 1255067880
875 EL CAJON BLVD
El Cajon, CA 92020
(619) 662-4100
✔ PECOS✔ Accepts MedicareSame address
Ahmed El-Ghoneimy, M.D.
Internal Medicine
NPI 1942257852
875 EL CAJON BLVD
El Cajon, CA 92020
(619) 662-4100
✔ PECOSSame address
Desiree Hsiou, DDS
Dentist
NPI 1699255281
875 EL CAJON BLVD
El Cajon, CA 92020
(619) 662-4100
✔ PECOS✔ Accepts MedicareSame address
Monis Khan, MD
Family Practice
NPI 1699517730
875 EL CAJON BLVD
El Cajon, CA 92020
(619) 662-4100
✔ PECOSSame address
Marylou Maldonado, RN, LMFT
Marriage and Family Therapist
NPI 1861704827
875 EL CAJON BLVD
El Cajon, CA 92020
(619) 662-4100
✔ PECOS✔ Accepts MedicareSame address
Sumana Reddy, MD
Allergy/Immunology
NPI 1053300251
875 EL CAJON BLVD
El Cajon, CA 92020
(619) 662-4100
✔ PECOS✔ Accepts MedicareSame address
Hala Sheikh-Mohamed, M.D
Internal Medicine
NPI 1972946770
875 EL CAJON BLVD
El Cajon, CA 92020
(619) 662-4100
✔ PECOS✔ Accepts MedicareSame address
Kim Wheeler, PSYD
Psychiatry
NPI 1700577434
875 EL CAJON BLVD
El Cajon, CA 92020
(619) 662-4100
✔ PECOS✔ Accepts MedicareSame address
Mohamed Baiou, M.D.
Family Practice
NPI 1447542659
525 E MAIN ST
El Cajon, CA 92020
(619) 515-2498
✔ PECOS✔ Accepts Medicare0.9 mi
Bassam Nassir, M.D.
Internal Medicine
NPI 1386848166
436 S MAGNOLIA AVE STE 201
El Cajon, CA 92020
(619) 662-4100
✔ PECOS✔ Accepts Medicare0.9 mi
Dalia Thomas, MSW
Clinical Social Worker
NPI 1104151372
436 S MAGNOLIA AVE SUITE 201
El Cajon, CA 92020
(619) 631-7400
✔ PECOS✔ Accepts Medicare0.9 mi
Sabah Mansour
Family Practice
NPI 1194388637
525 E MAIN ST
El Cajon, CA 92020
(619) 515-2498
✔ PECOS✔ Accepts Medicare1.4 mi
See all 576 clinicians

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 05D2034459

San Ysidro Health - El Cajon · El Cajon, CA
Active · expires Jun 23, 2028
CLIA Number05D2034459
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateJune 24, 2026
Certificate Expiration DateJune 23, 2028
Laboratory DirectorMaria Carriedo-Ceniceros
Laboratory Phone(619) 205-6392
Laboratory LocationSan Ysidro Health - El Cajon875 El Cajon Blvd, El Cajon, CA 92020
CLIA data matches this NPI record on: Address Name
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 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 1568845741. It was assigned to this organization in the NPPES registry on July 7, 2015. The provider is doing business as San Ysidro Health El Cajon/San Diego Pace.

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 875 El Cajon Blvd, El Cajon, CA 92020. 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, 16 practice at this address and 111 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Centro De Salud De La Comunidad De San Ysidro, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2034459) is associated with this NPI, valid through June 23, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

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 December 30, 2020. 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.