NPIMap

Organization Active NPI

City Wide Health Facility, Inc.

  • General Acute Care Hospital
  • Brooklyn, NY
National Provider Identifier
1013934025
Registry record updated Aug 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
7001103R Issued in NY
Legal business name
CITY WIDE HEALTH FACILITY, INC.
Practice address
201 Kings Hwy
Brooklyn, NY 11223-1106
Phone
(718) 621-1811
Fax
(718) 837-1274
NPI assigned
Jul 16, 2006
Last updated
Aug 20, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2015

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

Authorized official

Name
Mr. Larry Reznik
Title
Administrator
Phone
(718) 621-1811

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X
Medical Specialty Clinic/Center 261QM2500X
General Acute Care Hospital 282N00000X 7001103R NY Primary

Addresses

Primary practice location

201 Kings Hwy
Brooklyn, NY 11223-1106

Mailing address

201 Kings Hwy
Brooklyn, NY 11223-1106
Phone (718) 621-1811

Other identifiers 1

IdentifierTypeStateIssuer
02279954MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040316000493 NY Part B Supplier - Clinic/Group Practice 6608766688 Receives reassigned benefits from 24 practitioners
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

6817 Bay Pkwy
Brooklyn, NY 11204
Phone (718) 236-6800

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440028800000",
    "number": "1013934025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 KINGS HWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112231106",
            "telephone_number": "718-621-1811",
            "fax_number": "718-837-1274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 KINGS HWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112231106",
            "telephone_number": "718-621-1811",
            "fax_number": "718-837-1274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY WIDE HEALTH FACILITY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2015-08-20",
        "status": "A",
        "authorized_official_last_name": "REZNIK",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "718-621-1811",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NY",
            "license": "7001103R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02279954",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.