NPIMap

Organization Active NPI

Bronxcare Health System

Doing business as Ambulatory Care Network

  • Federally Qualified Health Center (FQHC)
  • Bronx, NY
National Provider Identifier
1053790147
Registry record updated May 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
7000001H Issued in NY
Legal business name
BRONXCARE HEALTH SYSTEM
Doing business as
Ambulatory Care Network
Practice address
1650 Grand Concourse
Bronx, NY 10457
Phone
(718) 901-8600
Fax
(718) 293-1457
NPI assigned
May 22, 2015
Last updated
May 31, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
BRONXCARE HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 31, 2018

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

Authorized official

Name
Mr. Victor G Demarco, CPA
Title
Senior VP-Chief Financial Officer
Phone
(718) 901-8600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 7000001H NY Primary

Addresses

Primary practice location

1650 Grand Concourse
Bronx, NY 10457

Mailing address

1276 Fulton Ave FL 3
Bronx, NY 10456-3402
Phone (718) 901-8600

Other identifiers 2

IdentifierTypeStateIssuer
000163NOtherNYBLUE CROSS
00476022MedicaidNY

Other names 1

  • Ambulatory Care Network Doing business as

National Provider Directory

National Provider Directory
Tax ID family
BLHC OBGYN GRP28 organizations share this tax ID, including this one
Part of
BLHC OBGYN GRP

Other organizations with this tax ID 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1432252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527724800000",
    "number": "1053790147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 FULTON AVE FL 3",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563402",
            "telephone_number": "718-901-8600",
            "fax_number": "718-293-1475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10457",
            "telephone_number": "718-901-8600",
            "fax_number": "718-293-1457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRONXCARE HEALTH SYSTEM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BRONXCARE HEALTH SYSTEM",
        "enumeration_date": "2015-05-22",
        "last_updated": "2018-05-31",
        "status": "A",
        "authorized_official_last_name": "DEMARCO",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "SENIOR VP-CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "718-901-8600",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NY",
            "license": "7000001H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000163N",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00476022",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ambulatory Care Network",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ambulatory Care Network",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.