NPIMap

Organization Active NPI

Housing Works Health Services III, Inc.

  • Federally Qualified Health Center (FQHC)
  • Brooklyn, NY
National Provider Identifier
1114950151
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
HOUSING WORKS HEALTH SERVICES III, INC.
Practice address
2640 Pitkin Ave
Brooklyn, NY 11208-2629
Phone
(718) 827-8700
Fax
(718) 827-5557
NPI assigned
Jul 9, 2006
Last updated
Oct 27, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
HOUSING WORKS HEALTH SERVICES III, INC.As reported in NPPES

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
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Primary Care Clinic/Center 261QP2300X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X

Addresses

Primary practice location

2640 Pitkin Ave
Brooklyn, NY 11208-2629

Mailing address

57 Willoughby St
Brooklyn, NY 11201-5257
Phone (718) 408-6522

Other identifiers 1

IdentifierTypeStateIssuer
01826104MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY5 enrollments

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
O20110930000487 NY Part B Supplier - Clinic/Group Practice 7113199852 Receives reassigned benefits from 37 practitioners
1 other NPI on this enrollment
Practice locations: Brooklyn, NY; New York, NY
O20131120001701 NY Part A Provider - Federally Qualified Health Center (FQHC) 7113199852 Practice locations: Brooklyn, NY
O20191223001058 NY Part A Provider - Federally Qualified Health Center (FQHC) 7113199852 Practice locations: New York, NY
O20230807002187 NY Part A Provider - Federally Qualified Health Center (FQHC) 7113199852 Practice locations: New York, NY
O20231206000360 NY Part A Provider - Federally Qualified Health Center (FQHC) 7113199852 Practice locations: New York, NY

NPI to CCN mapping 4

The Medicare certification numbers (CCNs) connected to NPI 1114950151. Details of each certification follow.

Federally qualified health center certification: CCN 331084

Legal name
HOUSING WORKS HEALTH SERVICES III INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 10, 2013
Last certification
Dec 10, 2013
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 6, 2003 in NY
Enrollment address
2640 Pitkin Ave
Brooklyn, NY 11208-2763

Federally qualified health center certification: CCN 571809

Legal name
HOUSING WORKS HEALTH SERVICES III INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 24, 2019
Last certification
Dec 24, 2019
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
in NY
Enrollment address
301 W 37TH St
FL 4
New York, NY 10018-4228

Federally qualified health center certification: CCN 331824

Legal name
HOUSING WORKS HEALTH SERVICES III INC
Doing business as
BAILEY HOUSE INC; PARK AVE HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 22, 2023
Last certification
Sep 22, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 15, 1995 in NY
Enrollment address
145 East 125TH Street
3Rd Floor
New York, NY 10035-1714

Federally qualified health center certification: CCN 571850

Legal name
HOUSING WORKS HEALTH SERVICES III INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 8, 2024
Last certification
Jan 8, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
326 W 48TH St
New York, NY 10036-1314

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Part of
Housing Works Inc Ai

Locations

1751 Park Ave
New York, NY 10035
Phone (212) 289-6008

320 W 30th St
New York, NY 10001
Phone (646) 775-5923

326 W 48th St
New York, NY 10036
Phone (415) 728-2839

Ownership & related parties

All disclosed owners & managing parties 17

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, 2012
Corporate Director Sep 1, 2011
Corporate DirectorBoard Member Sep 1, 2014
Housing Works, Inc. Organization, Brooklyn, NY Corporation, Non-profit 5% Or Greater Direct Ownership Interest Feb 15, 1995 100%
Frank Quintero Individual Corporate Director Sep 1, 2014
Corporate Director Sep 1, 2011
Corporate DirectorBoard Member Sep 1, 2014
Charles King Individual Corporate OfficerCeo Apr 24, 2004 100%
Corporate OfficerChief Executive Officer Apr 2, 2004 100%
Kathy Gueye Individual Corporate Director Sep 1, 2011
Corporate DirectorBoard Member Sep 1, 2014
Debora Carrero Individual Corporate Director Jan 1, 2020
Corporate Director May 1, 2019
W-2 Managing Employee May 1, 2019
Corporate Officer Jan 1, 2019
Corporate Director Jan 1, 2019
W-2 Managing Employee Jan 1, 2019
W-2 Managing EmployeeDirector of Credentialing Oct 1, 2023
Vaty M Poitevien Individual W-2 Managing EmployeeMD; Feb 14, 2023
Michelle Jackson Taylor Individual Corporate DirectorBoard Member Jun 13, 2025
Corporate DirectorBoard Sep 1, 2019
Corporate Director Sep 10, 2022
Cesar Figueroa Individual Corporate DirectorBoard Member Jun 13, 2025
Corporate Director Sep 1, 2019
Corporate DirectorBoard Member Jul 1, 2013
Marion Conde Individual Corporate Director Jul 1, 2013
Corporate Director Sep 1, 2011
Corporate Director Jun 1, 2016
Chenelle Nixon Individual Corporate Director Jul 1, 2013
Corporate Director Sep 1, 2011
Corporate DirectorBoard Member Jul 1, 2013
Jolanta Ilczuk Individual Corporate Director Aug 12, 2011
Corporate OfficerCfo Jul 1, 2023
W-2 Managing EmployeeCfo Jul 1, 2023
Germaine Norris Individual Corporate Director Sep 10, 2022
Yolanda Jasper Individual Corporate Director Sep 10, 2022
Daronne Hudson Individual Corporate Director Sep 1, 2019
Pamela de Cuir Johnson Individual Corporate Director Sep 10, 2022
Holland Glvanchi Individual Corporate Director Sep 10, 2022

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 59

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 59

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761523200000",
    "number": "1114950151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 WILLOUGHBY ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015257",
            "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": "2640 PITKIN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112082629",
            "telephone_number": "718-827-8700",
            "fax_number": "718-827-5557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOUSING WORKS HEALTH SERVICES III, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOUSING WORKS HEALTH SERVICES III, INC.",
        "enumeration_date": "2006-07-09",
        "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": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01826104",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.