NPIMap

Organization Active NPI

Sun River Health Inc

  • Federally Qualified Health Center (FQHC)
  • Bronx, NY
National Provider Identifier
1083197719
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
5901200R Issued in NY
Legal business name
SUN RIVER HEALTH INC
Practice address
2510 Westchester Avenue
Westchester Square Health Center
Bronx, NY 10461-3585
Phone
(855) 681-8700
Fax
(718) 299-1420
NPI assigned
Sep 10, 2018
Last updated
Mar 14, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
SUN RIVER HEALTH INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

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

Authorized official

Name
Emma E. McKinney
Title
Credentialing Supervisor
Phone
(845) 745-3611

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 5901200R NY Primary

Addresses

Primary practice location

2510 Westchester Avenue
Westchester Square Health Center
Bronx, NY 10461-3585

Mailing address

PO Box 5036
White Plains, NY 10602-5036
Phone (914) 734-8800

Other identifiers 2

IdentifierTypeStateIssuer
W38731OtherNYGROUP MEDICARE
00473038MedicaidNY

Other names 1

  • Westchester Square Health Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083197719. Details of each certification follow.

  • CCN 331181 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 331181

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
BRIGHTPOINT WESTCHESTER SQUARE CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 4, 2015
Last certification
Dec 4, 2015
Ownership / control type
For profit – corporation
Facility address
2510 Westchester Avenue
Bronx, NY 10461

National Provider Directory

National Provider Directory
Tax ID family
Michael J Gallina17 organizations share this tax ID, including this one
Part of
Michael J Gallina

Other organizations with this tax ID 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1536537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647216000000",
    "number": "1083197719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5036",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106025036",
            "telephone_number": "914-734-8800",
            "fax_number": "914-734-8786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 WESTCHESTER AVENUE",
            "address_2": "WESTCHESTER SQUARE HEALTH CENTER",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104613585",
            "telephone_number": "855-681-8700",
            "fax_number": "718-299-1420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN RIVER HEALTH INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUN RIVER HEALTH INC",
        "enumeration_date": "2018-09-10",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A",
        "authorized_official_last_name": "MCKINNEY",
        "authorized_official_first_name": "EMMA",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
        "authorized_official_telephone_number": "845-745-3611"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NY",
            "license": "5901200R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "W38731",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00473038",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Westchester Square Health Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Westchester Square Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.