NORTHEAST COMMUNITY CLINIC
NPI 1891200325
Clinic/Center - Federally Qualified Health Center (FQHC) in Los Angeles, CA

Active since December 06, 2017
1414 S GRAND AVE STE 380, LOS ANGELES, CA 90015(213) 222-1300(213) 222-1333 Get Directions Write a Review

NPPES record last updated: October 15, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 15, 2021, Dec 6, 2017 (2 updates tracked since 2017).

About Northeast Community Clinic NPPES

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

NORTHEAST COMMUNITY CLINIC (NPI 1891200325) is a healthcare organization registered as a federally qualified health center (fqhc) in Los Angeles, California and active in the NPI registry since December 2017. The organization lists Christopher Tak Lau, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1891200325
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameNORTHEAST COMMUNITY CLINIC
Location Address1414 S GRAND AVE STE 380Los Angeles, CA 90015-3072
Mailing Address2550 W Main St Ste 301Alhambra, CA 91801-7003 · (626) 457-6900 · Fax (626) 457-5022
Fax(213) 222-1333
Organization SubpartYes
Authorized OfficialChristopher Tak LauExecutive Director · (626) 457-6900
Enumeration DateDecember 6, 2017
Last NPPES UpdateOctober 15, 20212 updates tracked since enumeration
NPPES CertifiedOctober 15, 2021
✔ NPI 1891200325 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
1414 S GRAND AVE STE 380, Los Angeles, CA 90015

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)

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

Medicare Revalidation Due Date

Revalidation due by March 31, 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.

StateEnrollment IDDue date
StateCaliforniaEnrollment IDO20040417000619Non-DME Part B · Clinic/Group PracticeDue dateMarch 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

45

Medicare enrollment records show 45 clinicians reassign Medicare billing to Northeast Community Clinic, which bills Medicare for the services they deliver. Of these, 8 practice at this address and 29 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 9

Family Practice11
Pediatric Medicine9
Clinical Social Worker6
Nurse Practitioner6
Internal Medicine4
Obstetrics/Gynecology4
Dentist3
Optometry1
1 other specialty1

Nearest to this location (20)

See all 45
Nurse Practitioner
NPI 1770431637
1414 S GRAND AVE STE 380
Los Angeles, CA 90015
(213) 743-9000
✔ PECOSSame address
Pediatric Medicine
NPI 1609818152
1414 S GRAND AVE STE 380
Los Angeles, CA 90015
(213) 743-9000
✔ PECOSSame address
Nurse Practitioner
NPI 1801689526
1414 S GRAND AVE STE 456
Los Angeles, CA 90015
(213) 745-6047
✔ PECOSSame address
Internal Medicine
NPI 1558375022
1414 S GRAND AVE STE 380
Los Angeles, CA 90015
(213) 222-1300
✔ PECOSSame address
Clinical Social Worker
NPI 1215584974
1414 S GRAND AVE STE 380
Los Angeles, CA 90015
(213) 743-9000
✔ PECOSSame address
Family Practice
NPI 1700086337
1414 S GRAND AVE STE 380
Los Angeles, CA 90015
(213) 222-1300
✔ PECOSSame address
Pediatric Medicine
NPI 1740817691
1414 S GRAND AVE STE 200
Los Angeles, CA 90015
(626) 457-5515
✔ PECOSSame address
Internal Medicine
NPI 1285088328
1414 S GRAND AVE STE 456
Los Angeles, CA 90015
(323) 256-3884
✔ PECOSSame address
Dentist
NPI 1043887235
2975 ZOE AVE
Huntington Park, CA 90255
(323) 826-9449
✔ PECOS✔ Accepts Medicare4.9 mi
Pediatric Medicine
NPI 1306072277
4129 GAGE AVE
Bell, CA 90201
(323) 771-8400
✔ PECOS5.8 mi
Family Practice
NPI 1265771356
4129 GAGE AVE
Bell, CA 90201
(323) 771-8400
✔ PECOS✔ Accepts Medicare5.8 mi
Obstetrics/Gynecology
NPI 1841248820
8475 S VAN NESS AVE SUITE 101
Inglewood, CA 90305
(323) 778-7990
✔ PECOS✔ Accepts Medicare6.1 mi
Pediatric Medicine
NPI 1386879807
5420 N FIGUEROA ST
Los Angeles, CA 90042
(323) 256-3884
✔ PECOS6.3 mi
Nurse Practitioner
NPI 1902648470
5420 N FIGUEROA ST
Los Angeles, CA 90042
(323) 256-3884
✔ PECOS6.3 mi
Clinical Social Worker
NPI 1144341710
5420 N FIGUEROA ST
Los Angeles, CA 90042
(323) 325-6388
✔ PECOS✔ Accepts Medicare6.3 mi
Family Practice
NPI 1588770531
5420 N FIGUEROA ST
Los Angeles, CA 90042
(323) 256-3884
✔ PECOS✔ Accepts Medicare6.3 mi
Internal Medicine
NPI 1902240229
5420 N FIGUEROA ST
Los Angeles, CA 90042
(323) 254-3884
✔ PECOS✔ Accepts Medicare6.3 mi
Clinical Social Worker
NPI 1962832261
5420 N FIGUEROA ST
Los Angeles, CA 90042
(323) 256-3884
✔ PECOS6.3 mi
Internal Medicine
NPI 1033573241
4455 W 117TH ST STE 502
Hawthorne, CA 90250
(424) 236-4800
✔ PECOS✔ Accepts Medicare9.0 mi
Optometry
NPI 1083097760
4455 W 117TH ST STE 105
Hawthorne, CA 90250
(424) 456-6200
✔ PECOS9.0 mi
See all 45 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 Northeast Community Clinic's NPI number?

The NPI number for Northeast Community Clinic is 1891200325. It was assigned to this organization in the NPPES registry on December 6, 2017.

Where is Northeast Community Clinic located?

Northeast Community Clinic is located at 1414 S Grand Ave Ste 380, Los Angeles, CA 90015. The listed phone number is (213) 222-1300.

What is Northeast Community Clinic's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Is Northeast Community Clinic enrolled in Medicare?

Yes. Northeast Community Clinic is registered in the Medicare PECOS enrollment system.

When is Northeast Community Clinic'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 March 31, 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 Northeast Community Clinic?

According to the CMS Revalidation Reassignment List (October 2026 release), 45 clinicians in 9 Medicare specialties reassign their Medicare billing to Northeast Community Clinic. 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 (11), Pediatric Medicine (9) and Clinical Social Worker (6). Of these, 8 practice at this address and 29 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Northeast Community Clinic was last updated on October 15, 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.