AMPLA HEALTH GRIDLEY MEDICAL
NPI 1639194004
Clinic/Center - Federally Qualified Health Center (FQHC) in Gridley, CA
About Ampla Health Gridley Medical NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
AMPLA HEALTH GRIDLEY MEDICAL (NPI 1639194004) is a healthcare organization registered as a federally qualified health center (fqhc) in Gridley, California and active in the NPI registry since July 2006. The organization lists Benjamin H Flores, President, Chief Executive Officer, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Other Identifiers 3
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Ampla Health Gridley Medical is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by February 28, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
126Medicare enrollment records show 126 clinicians reassign Medicare billing to Ampla Health Gridley Medical, which bills Medicare for the services they deliver. Of these, 1 practice at this address. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 23
Nearest to this location (20)
See all 126Source: 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 Ampla Health's NPI number?
The NPI number for Ampla Health is 1639194004. It was assigned to this organization in the NPPES registry on July 13, 2006. The provider is also known as Ampla Health Gridley Medical.
Where is Ampla Health located?
Ampla Health is located at 520 Kentucky St, Gridley, CA 95948. The listed phone number is (530) 846-6231.
What is Ampla 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 Ampla Health enrolled in Medicare?
Yes. Ampla Health is registered in the Medicare PECOS enrollment system.
When is Ampla Health's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (California, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Ampla Health?
According to the CMS Revalidation Reassignment List (October 2026 release), 126 clinicians in 23 Medicare specialties reassign their Medicare billing to Ampla 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 (45), Internal Medicine (13) and Pediatric Medicine (12). Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Ampla Health was last updated on February 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Ampla Health Gridley Medical · NPI 1639194004
Federally Qualified Health Center (FQHC) organization in Gridley, California. Organization record, active in the CMS NPPES registry since July 13, 2006.
## Identity
- **NPI:** 1639194004 (Entity type: Organization)
- **Enumerated:** July 13, 2006
- **Primary specialty:** Clinic/Center - Federally Qualified Health Center (FQHC) · taxonomy 261QF0400X
- **Legal business name:** Ampla Health
- **Organization subpart:** No
- **Authorized official:** Benjamin Flores, PRESIDENT, CHIEF EXECUTIVE OFFICER
## Practice location
- **Address:** 520 KENTUCKY ST, Gridley, CA 95948-2116
- **Phone:** (530) 846-6231 · **Fax:** (530) 846-4051
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** February 28, 2027 (Non-DME Part B, California, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 126 clinicians in 23 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (45), Internal Medicine (13), Pediatric Medicine (12); 1 practice at this address; [full list](https://npiprofile.com/npi/1639194004/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 29, 2024
- **Other identifiers:** Other HAP03878F (CA); Other BCP03878F (CA); Medicaid 1865025 (CA)
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Source: [NPI Profile](https://npiprofile.com/npi/1639194004) · Data from the CMS NPPES public registry.