NPIMap

Organization Active NPI

William F Ryan Community Health Center Inc

Doing business as Ryan Health Midtown Emotional Wellness Center

  • Federally Qualified Health Center (FQHC)
  • New York, NY
National Provider Identifier
1043079064
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
WILLIAM F RYAN COMMUNITY HEALTH CENTER INC
Doing business as
Ryan Health Midtown Emotional Wellness Center
Practice address
64 W 35TH St FL 3
New York, NY 10001-2201
Phone
(212) 749-1820
NPI assigned
Mar 14, 2024
Last updated
Nov 21, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
WILLIAM F RYAN COMMUNITY HEALTH CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Authorized official

Name
Jose Virella
Title
Chief Financial Officer
Phone
(212) 316-7906

Specialties & licenses 1

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

Addresses

Primary practice location

64 W 35TH St FL 3
New York, NY 10001-2201

Mailing address

64 W 35TH St FL 3
New York, NY 10001-2201
Phone (212) 749-1820

Other names 1

  • Ryan Health Midtown Emotional Wellness Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240926003104 NY Part A Provider - Federally Qualified Health Center (FQHC) 4880596550 Practice locations: New York, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043079064. Details of each certification follow.

Federally qualified health center certification: CCN 571871

Legal name
WILLIAM F RYAN COMMUNITY HEALTH CENTER INC
Doing business as
RYAN HEALTH MIDTOWN EMOTIONAL WELLNESS CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 24, 2024
Last certification
Sep 24, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 1, 1977 in NY
Enrollment address
64 W 35TH St
New York, NY 10001-2201

Other NPIs with the same Medicare PAC ID 7

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

National Provider Directory

National Provider Directory
Tax ID family
Jeannetta M Bushey13 organizations share this tax ID, including this one
Part of
Jeannetta M Bushey

Other organizations with this tax ID 12

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

Locations

154 Wadsworth Ave
New York, NY 10033
Phone (212) 531-7589

2381 Frederick Douglass Blvd
New York, NY 10027
Phone (212) 749-6626

279 E 3rd St
New York, NY 10009
Phone (212) 477-8500

64 W 35th St
#3
New York, NY 10001
Phone (212) 645-0875

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Harriet King Individual Corporate DirectorBoard Member Jan 1, 1989
Alicia Y Henderson Individual W-2 Managing EmployeeChief of Bahavior Health Sep 1, 2022
Philip Chen Individual Corporate DirectorBoard Member Jul 31, 2015
Margaret Gramins Individual Corporate DirectorBoard Member Jun 5, 2017
Lois Dorman Individual Corporate DirectorBoard Member Jul 1, 2019
Hope Mason Individual Corporate DirectorBoard Member Jan 1, 1987
Atif Abdul Haqq Individual Corporate DirectorBoard Member Oct 9, 2013
Juli a Harkins Individual Corporate DirectorBoard Member Jul 1, 2016
Ronald Guy Individual Corporate DirectorBoard Member President Feb 2, 2000
Joseph Haslip Individual Corporate DirectorBoard Member Jan 1, 2013
Daniel Pichinson Individual Corporate OfficerPresident & Chief Executive Officer Jan 6, 2024
Ronnie Lowenstein Individual Corporate DirectorBoard Member Tresurer Nov 6, 2017

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 195

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 195

NPI Registry JSON

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

{
    "created_epoch": "1710374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732147200000",
    "number": "1043079064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 W 35TH ST FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100012201",
            "telephone_number": "212-749-1820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 W 35TH ST FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100012201",
            "telephone_number": "212-749-1820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM F RYAN COMMUNITY HEALTH CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WILLIAM F RYAN COMMUNITY HEALTH CENTER INC",
        "enumeration_date": "2024-03-14",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A",
        "authorized_official_last_name": "VIRELLA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "212-316-7906"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ryan Health Midtown Emotional Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ryan Health Midtown Emotional Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.