GRACELIGHT COMMUNITY HEALTH
NPI 1801967062
Clinic/Center - Federally Qualified Health Center (FQHC) in Los Angeles, CA

Active since November 10, 2006CLIA 05D0957562 · Waiver
4448 YORK BLVD, LOS ANGELES, CA 90041(323) 344-5233(323) 344-5237 Get Directions Write a Review

NPPES record last updated: June 27, 2024. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Jun 27, 2024, Jan 26, 2021 (2 updates tracked since 2021).

About Gracelight Community Health NPPES

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

GRACELIGHT COMMUNITY HEALTH (NPI 1801967062), doing business as Queenscare Health Centers, is a healthcare organization registered as a federally qualified health center (fqhc) in Los Angeles, California and active in the NPI registry since November 2006. The organization holds a CLIA Waiver certificate valid through February 22, 2027 and lists Eloisa Perard, President & Ceo, as its authorized official.

NPPES Registry Identity

NPI1801967062
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameGRACELIGHT COMMUNITY HEALTH
Location Address4448 YORK BLVDLos Angeles, CA 90041-3328
Mailing Address4816 E 3rd StLos Angeles, CA 90022-1602 · (323) 780-4510 · Fax (323) 981-1662
Fax(323) 344-5237
Organization SubpartNo
Authorized OfficialEloisa PerardPresident & Ceo · (323) 669-4321
Enumeration DateNovember 10, 2006
Last NPPES UpdateJune 27, 20242 updates tracked since enumeration
NPPES CertifiedJune 27, 2024
✔ NPI 1801967062 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
License✔ Licensed in CA · 960001125
4448 YORK BLVD, Los Angeles, CA 90041

Other Names 1

Former Legal Business NameQueenscare Health Centers

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Gracelight Community Health is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

75

Medicare enrollment records show 75 clinicians reassign Medicare billing to Gracelight Community Health, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 48 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 11

Nurse Practitioner16
Obstetrics/Gynecology12
Family Practice11
Pediatric Medicine10
Dentist8
Internal Medicine5
Optometry5
Clinical Social Worker3
3 other specialties5

Nearest to this location (20)

See all 75
Nurse Practitioner
NPI 1134533318
4448 YORK BLVD
Los Angeles, CA 90041
(323) 344-5233
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1831146174
4448 YORK BLVD
Los Angeles, CA 90041
(323) 344-5233
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1285912741
4448 YORK BLVD
Los Angeles, CA 90041
(323) 344-5233
✔ PECOS✔ Accepts MedicareSame address
Dentist
NPI 1841465721
4448 YORK BLVD
Los Angeles, CA 90041
(323) 344-5233
✔ PECOSSame address
Pediatric Medicine
NPI 1356308167
1332 S GLENDALE AVE
Glendale, CA 91205
(818) 241-7147
✔ PECOS2.0 mi
Obstetrics/Gynecology
NPI 1265708655
1560 E CHEVY CHASE DR STE 450
Glendale, CA 91206
(818) 660-2200
✔ PECOS✔ Accepts Medicare2.1 mi
Obstetrics/Gynecology
NPI 1982799953
222 W EULALIA ST SUITE 211
Glendale, CA 91204
(818) 502-4567
✔ PECOS✔ Accepts Medicare2.2 mi
Family Practice
NPI 1730614652
1220 S CENTRAL AVE STE 105
Glendale, CA 91204
(818) 545-9539
✔ PECOS✔ Accepts Medicare2.3 mi
Nurse Practitioner
NPI 1922770874
1891 EFFIE ST
Los Angeles, CA 90026
(323) 644-2000
✔ PECOS✔ Accepts Medicare3.5 mi
Obstetrics/Gynecology
NPI 1043305774
711 W COLLEGE ST SUITE 540
Los Angeles, CA 90012
(213) 626-5151
✔ PECOS✔ Accepts Medicare4.2 mi
Pediatric Medicine
NPI 1902426703
4650 W SUNSET BLVD
Los Angeles, CA 90027
(323) 361-2122
✔ PECOS4.5 mi
Podiatry
NPI 1568769149
4618 FOUNTAIN AVE
Los Angeles, CA 90029
(323) 953-7170
✔ PECOS✔ Accepts Medicare4.5 mi
Nurse Practitioner
NPI 1932427796
4650 SUNSET BOULEVARD CHILDRENS HOSPITAL LOS ANGELES
Los Angeles, CA 90027
(323) 361-2533
✔ PECOS4.5 mi
Internal Medicine
NPI 1275576845
4618 FOUNTAIN AVE
Los Angeles, CA 90029
(323) 953-7170
✔ PECOS✔ Accepts Medicare4.5 mi
Family Practice
NPI 1689713380
4618 FOUNTAIN AVE
Los Angeles, CA 90029
(323) 953-7170
✔ PECOS4.5 mi
Optometry
NPI 1679642243
4618 FOUNTAIN AVE
Los Angeles, CA 90029
(323) 953-7191
✔ PECOS4.5 mi
Dentist
NPI 1972541654
4618 FOUNTAIN AVE
Los Angeles, CA 90029
(323) 953-7170
✔ PECOS4.5 mi
Optometry
NPI 1265165559
1300 N VERMONT AVE STE 101
Los Angeles, CA 90027
(183) 327-0393
✔ PECOS✔ Accepts Medicare4.6 mi
Dentist
NPI 1528317070
680 E COLORADO BLVD SUITE 180 AND 2ND FLOOR
Pasadena, CA 91101
(917) 340-1055
✔ PECOS5.0 mi
Internal Medicine
NPI 1427370618
150 N RENO ST
Los Angeles, CA 90026
(213) 380-7298
✔ PECOS✔ Accepts Medicare5.0 mi
See all 75 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 05D0957562

Gracelight Community Health · Los Angeles, CA
Active · expires Feb 22, 2027
CLIA Number05D0957562
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateFebruary 23, 2025
Certificate Expiration DateFebruary 22, 2027
Laboratory DirectorDeanah A. Jibril
Laboratory Phone(323) 344-5233
Laboratory LocationGracelight Community Health4448 York Blvd, Los Angeles, CA 90041
CLIA data matches this NPI record on: Address 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 Gracelight Community Health's NPI number?

The NPI number for Gracelight Community Health is 1801967062. It was assigned to this organization in the NPPES registry on November 10, 2006. The provider was formerly known as Queenscare Health Centers.

Where is Gracelight Community Health located?

Gracelight Community Health is located at 4448 York Blvd, Los Angeles, CA 90041. The listed phone number is (323) 344-5233.

What is Gracelight Community 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 Gracelight Community Health enrolled in Medicare?

Yes. Gracelight Community Health is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Gracelight Community Health?

According to the CMS Revalidation Reassignment List (October 2026 release), 75 clinicians in 11 Medicare specialties reassign their Medicare billing to Gracelight Community 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 (16), Obstetrics/Gynecology (12) and Family Practice (11). Of these, 4 practice at this address and 48 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Gracelight Community Health hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0957562) is associated with this NPI, valid through February 22, 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 Gracelight Community Health was last updated on June 27, 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.