NPIMap

Organization Active NPI

Aizer Health , Inc.

  • Federally Qualified Health Center (FQHC)
  • Monroe, NY
National Provider Identifier
1063480218
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
AIZER HEALTH , INC.
Practice address
49 Forest Road
Monroe, NY 10950-2923
Phone
(845) 782-3242
Fax
(845) 783-7133
NPI assigned
Mar 14, 2006
Last updated
Aug 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Authorized official

Name
Joel Mittelman
Title
Executive Director
Phone
(845) 782-3242

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

49 Forest Road
Monroe, NY 10950-2923

Mailing address

49 Forest Road
Monroe, NY 10950-2923
Phone (845) 782-3242

Other identifiers 1

IdentifierTypeStateIssuer
01620680MedicaidNY

Other names 1

  • Ezras Choilim Health Center, Inc. Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040323001580 NY Part B Supplier - Clinic/Group Practice 6406747989 Receives reassigned benefits from 106 practitioners
Practice locations: Monroe, NY
O20100729000435 NY Part A Provider - Federally Qualified Health Center (FQHC) 6406747989 Practice locations: Monroe, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063480218. Details of each certification follow.

Federally qualified health center certification: CCN 331949

Legal name
AIZER HEALTH , INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 25, 2005
Last certification
Mar 25, 2005
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 26, 1992 in NY
Enrollment address
49 Forest Rd
Monroe, NY 10950-2923

Other NPIs with the same Medicare PAC ID 2

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0965257Aizer Health Inc49 Forest Rd, Monroe, NY 10950ComplianceMar 26, 2027
33D2273756Aizer Health Inc49 Forest Rd, Monroe, NY 10950Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

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
Martin Schlesinger Individual Corporate Director Jul 11, 2011
Joel Mittelman Individual Corporate DirectorCeo Apr 18, 2010
W-2 Managing Employee Apr 18, 2010
Nusen Weinstock Individual Corporate Director Jan 1, 2004
Ronald Cohen Individual Corporate Director Jan 1, 1996
Moses Goldstein Individual Corporate Director May 3, 2009
Esther Rubenstein Individual Corporate Director Jun 3, 2009
Abraham Wieder Individual Corporate Director Jan 1, 2008
Pinchas Kish Individual Corporate Director Jan 1, 2005
Isreal Sofer Individual Corporate Director Jan 1, 1996
Noemi Weiss Individual Corporate Director May 3, 2009
Chaim Wertzberger Individual Corporate Director Jan 1, 2002
Esther Srugo Individual Corporate Director May 3, 2009

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 112

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 112

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723680000000",
    "number": "1063480218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 FOREST ROAD",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109502923",
            "telephone_number": "845-782-3242",
            "fax_number": "845-783-7133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 FOREST ROAD",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109502923",
            "telephone_number": "845-782-3242",
            "fax_number": "845-783-7133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AIZER HEALTH , INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-14",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A",
        "authorized_official_last_name": "MITTELMAN",
        "authorized_official_first_name": "JOEL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "845-782-3242"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01620680",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ezras Choilim Health Center, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Monroe, NY

Sources for this page

Verify at the official NPI Registry.