NPIMap

Organization Active NPI

Care for the Homeless

Doing business as Citadel Health Center

  • Federally Qualified Health Center (FQHC)
  • Jamaica, NY
National Provider Identifier
1013253327
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
70000279R Issued in NY
Legal business name
CARE FOR THE HOMELESS
Doing business as
Citadel Health Center
Practice address
9023 161St St
Jamaica, NY 11432-6107
Phone
(718) 709-5054
Fax
(212) 366-1773
NPI assigned
Dec 14, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
John Chue, CPA, CGMA
Title
Chief Financial Officer
Phone
(212) 366-4459

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 70000279R NY Primary

Addresses

Primary practice location

9023 161St St
Jamaica, NY 11432-6107

Mailing address

30 E 33Rd St
New York, NY 10016-5337
Phone (212) 366-4459

Other names 1

  • Citadel Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150325000236 NY Part A Provider - Federally Qualified Health Center (FQHC) 9830240332 Practice locations: Jamaica, NY

Federally qualified health center certification: CCN 331146

Legal name
CARE FOR THE HOMELESS
Doing business as
CITADEL HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 26, 2015
Last certification
May 26, 2015
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 1, 1992 in NY
Enrollment address
90-23 161St Street
Jamaica, NY 11432-6107

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Care for the Homeless12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

9023 161st St
Jamaica, NY 11432
Phone (718) 709-5054

Ownership & related parties

All disclosed owners & managing parties 20

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Fulvia Frazier Individual Corporate OfficerBoard Member Jan 1, 2023
Corporate DirectorBoard Member Jan 1, 2023
David Ruan Individual Corporate OfficerChief Financial Officer Jul 21, 2025
Corporate DirectorChief Financial Officer Jul 21, 2025
W-2 Managing Employee Jul 21, 2025
Timothy Karcher Individual Corporate OfficerBoard Member Jan 1, 2023
Corporate DirectorBoard Member Jan 1, 2023
Lloyd E Bailey Individual Corporate OfficerChair of Cqi Jan 1, 2023
Corporate DirectorChair of Cqi Jan 1, 2023
Philip Malebranche Individual Corporate OfficerChair of Policy & Advocacy Jan 1, 2023
Corporate DirectorChair of Policy & Advocacy Jan 1, 2023
Allen Rumanyika Individual Corporate OfficerBoard Treasurer Jan 1, 2023
Corporate DirectorBoard Treasurer Jan 1, 2023
Janardhan Cadambi Individual Corporate OfficerChair of Audit & Compliance Jan 1, 2023
Corporate DirectorChair of Audit & Compliance Jan 1, 2023
Frances a Melendez Individual Corporate OfficerBoard Member Jan 1, 2023
Corporate DirectorBoard Member Jan 1, 2023
Judy Tabak Individual Corporate OfficerBoard Secretary Jan 1, 2023
Corporate DirectorBoard Secretary Jan 1, 2023
Marian Haas Individual Corporate OfficerBoard Member Jan 1, 2023
Corporate DirectorBoard Member Jan 1, 2023
Kai-Chun Chue Individual Corporate OfficerChief Financial Officer Jan 1, 2020
Corporate DirectorChief Financial Officer Jan 1, 2020
W-2 Managing EmployeeChief Financial Officer Jan 1, 2020
Jane Parker Individual Corporate OfficerBoard Member Jan 1, 2023
Corporate DirectorBoard Member Jan 1, 2023
Jonathan Dwayne Santos-Ramos Individual Corporate OfficerChief Program Officer Jun 5, 2023
Corporate DirectorChief Program Officer Jun 5, 2023
George Nashak Individual Corporate OfficerPresident and Ceo Jan 1, 2017
Corporate DirectorPresident and Ceo Jan 1, 2017
Surjit Chana Individual Corporate OfficerBoard Chair Jan 1, 2023
Corporate DirectorBoard Chair Jan 1, 2023
Delise Dupont Blenman Individual Corporate OfficerBoard Member Jan 1, 2023
Corporate DirectorBoard Member Jan 1, 2023
Harry K Thomas Individual Corporate OfficerChair of Development Communications Jan 1, 2023
Corporate DirectorChair of Development Communications Jan 1, 2023
Robert Heckart Individual Corporate OfficerBoard Vice Chair Jan 1, 2023
Corporate DirectorBoard Vice Chair Jan 1, 2023
Grigor Licul Individual Corporate OfficerBoard Member Jan 1, 2023
Corporate DirectorBoard Member Jan 1, 2023
Amanda Fialk Individual Corporate OfficerBoard Member Jan 1, 2023
Corporate DirectorBoard Member Jan 1, 2023

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1355443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715299200000",
    "number": "1013253327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 E 33RD ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165337",
            "telephone_number": "212-366-4459",
            "fax_number": "212-366-1773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9023 161ST ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114326107",
            "telephone_number": "718-709-5054",
            "fax_number": "212-366-1773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARE FOR THE HOMELESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-14",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A",
        "authorized_official_last_name": "CHUE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "212-366-4459",
        "authorized_official_credential": "CPA, CGMA"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NY",
            "license": "70000279R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Citadel Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.