NPIMap

Organization Active NPI

Miami Beach Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Miami, FL
National Provider Identifier
1104357565
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MIAMI BEACH COMMUNITY HEALTH CENTER INC
Practice address
11645 Biscayne Blvd Ste 302&304
Miami, FL 33181-3155
Phone
(305) 538-8835
Fax
(305) 994-0054
NPI assigned
Mar 27, 2017
Last updated
Dec 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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

Authorized official

Name
Mark Rabinowitz, MDNPI 1326068842
Title
Chief Executive Officer
Phone
(305) 538-8835

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

11645 Biscayne Blvd Ste 302&304
Miami, FL 33181-3155

Mailing address

11645 Biscayne Blvd Ste 207
North Miami, FL 33181-3138
Phone (305) 538-8835

Other identifiers 1

IdentifierTypeStateIssuer
029544224MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040811001125 FL Part B Supplier - Clinic/Group Practice 8123090925 Receives reassigned benefits from 97 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: North Miami, FL; Miami Beach, FL; Miami, FL
O20180103003337 FL Part A Provider - Federally Qualified Health Center (FQHC) 8123090925 Practice locations: Miami, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104357565. Details of each certification follow.

Federally qualified health center certification: CCN 681121

Legal name
MIAMI BEACH COMMUNITY HEALTH CENTER, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 5, 2018
Last certification
Jan 5, 2018
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 1, 1977 in FL
Enrollment address
11645 Biscayne Blvd, Ste 302 & 304
Miami, FL 33181-3155

Other NPIs with the same Medicare PAC ID 9

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

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Miami Beach Community Health Center Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

11645 Biscayne Blvd
Ste 309
North Miami, FL 33181
Phone (867) 920-2021

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Denise Novack Individual Corporate DirectorBoard of Directors Mar 1, 2012
Barbara Lambert Individual Corporate DirectorBoard of Directors Feb 1, 2022
S Yonne Saint Gerard Individual Corporate DirectorBoard of Directors Apr 1, 2010
David Chamberlain Individual Corporate DirectorBoard of Directors Nov 1, 2012
Melvin P Deutsch Individual Corporate DirectorBoard of Directors Apr 1, 2001
Mitchell Rubinson Individual Corporate DirectorBoard of Directors Nov 1, 2012
Beverly Penzell Individual Corporate DirectorBoard of Directors Feb 1, 2022
Alan Layng Individual Corporate DirectorCfo Apr 1, 2019
W-2 Managing EmployeeCfo Apr 1, 2019
Mabel Velez Individual Corporate DirectorBoard of Directors Feb 1, 2022
David Gersten Individual Corporate DirectorBoard of Directors Nov 1, 2012
Therese Gibb Individual Corporate DirectorBoard of Directors Nov 1, 2012
David Massey Individual Corporate DirectorBoard of Directors Jun 1, 2014
Mark L Rabinowitz Individual Corporate DirectorPresident/Ceo Aug 6, 2012
W-2 Managing EmployeePresident/Ceo Aug 6, 2012 100%

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 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734912000000",
    "number": "1104357565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11645 BISCAYNE BLVD STE 207",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331813138",
            "telephone_number": "305-538-8835",
            "fax_number": "305-938-4044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11645 BISCAYNE BLVD STE 302&304",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331813155",
            "telephone_number": "305-538-8835",
            "fax_number": "305-994-0054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIAMI BEACH COMMUNITY HEALTH CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-27",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A",
        "authorized_official_last_name": "RABINOWITZ",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "305-538-8835",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "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": "029544224",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.