NPIMap

Organization Active NPI

Bailey House Inc

  • Federally Qualified Health Center (FQHC)
  • New York, NY
National Provider Identifier
1083820583
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
BAILEY HOUSE INC
Practice address
145 E 125TH St FL 4
4TH Floor
New York, NY 10035-1714
Phone
(718) 277-0386
Fax
(929) 480-9133
NPI assigned
May 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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

Authorized official

Name
Debora Carrero
Title
Director of Credentialing
Phone
(718) 408-6522

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Community/Behavioral Health Agency 251S00000X 8124001A NY
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

145 E 125TH St FL 4
4TH Floor
New York, NY 10035-1714

Mailing address

145 E 125TH St FL 4
New York, NY 10035-1714
Phone (718) 408-6522

Other identifiers 1

IdentifierTypeStateIssuer
02822911MedicaidNY

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170125003003 NY Part B Supplier - Clinic/Group Practice 4385870203 Receives reassigned benefits from 13 practitioners
Practice locations: New York, NY
O20200415000408 NY Part A Provider - Federally Qualified Health Center (FQHC) 4385870203 Practice locations: New York, NY

Federally qualified health center certification: CCN 571800

Legal name
BAILEY HOUSE INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 30, 2020
Last certification
Apr 30, 2020
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 2, 1983 in NY
Enrollment address
145 E 125TH St
FL 3-4
New York, NY 10035-1714

National Provider Directory

National Provider Directory
Tax ID family
Bailey House Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

145 E 125th St
Fl 4
New York, NY 10035
Phone (718) 249-0763

1751 Park Ave
Fl 4
New York, NY 10035

145 E 125th St
Fl 34
New York, NY 10035

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Matthew Bernardo Individual Corporate Director Sep 1, 2019
Chenelle Nixon Individual Corporate Director Sep 1, 2019
Charles King Individual Corporate Director Sep 1, 2019
Kathy Gueye Individual Corporate Director Sep 1, 2019
Debora Carrero Individual Corporate Director Jan 1, 2019
W-2 Managing Employee Apr 1, 2020
Cesar Figueroa Individual Corporate Director Sep 1, 2019
Marion Conde Individual Corporate Director Sep 1, 2019

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761523200000",
    "number": "1083820583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 E 125TH ST FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100351714",
            "telephone_number": "718-408-6522",
            "fax_number": "929-480-9133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 E 125TH ST FL 4",
            "address_2": "4TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100351714",
            "telephone_number": "718-277-0386",
            "fax_number": "929-480-9133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAILEY HOUSE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A",
        "authorized_official_last_name": "CARRERO",
        "authorized_official_first_name": "DEBORA",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "718-408-6522"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NY",
            "license": "8124001A",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02822911",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.