NPIMap

Organization Active NPI

Joseph P. Addabbo Family Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Ozone Park, NY
National Provider Identifier
1134476443
Registry record updated Feb 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
7003234R Issued in NY
Legal business name
JOSEPH P. ADDABBO FAMILY HEALTH CENTER, INC.
Practice address
105-34 Rockaway Boulevard
Ozone Park, NY 11417
Phone
(718) 945-7150
Fax
(718) 945-2596
NPI assigned
Aug 7, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2016

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

Authorized official

Name
Dr. Marjorie J. Hill, PHD
Title
Ceo
Phone
(718) 945-7150

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 7003234R NY Primary

Addresses

Primary practice location

105-34 Rockaway Boulevard
Ozone Park, NY 11417

Mailing address

6200 Beach Channel Drive
Arverne, NY 11692
Phone (718) 945-7150

Other identifiers 1

IdentifierTypeStateIssuer
00990152MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160921001025 NY Part B Supplier - Clinic/Group Practice 0749174654 Receives reassigned benefits from 33 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Arverne, NY; Brooklyn, NY; Far Rockaway, NY; Jamaica, NY

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory

Locations

190 Beach 68th St
Arverne, NY 11692

11439 Sutphin Blvd
Jamaica, NY 11434

Practitioners & affiliated clinicians

Practitioners 60

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

View all 60

NPI Registry JSON

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

{
    "created_epoch": "1344297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454544000000",
    "number": "1134476443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 BEACH CHANNEL DRIVE",
            "city": "ARVERNE",
            "state": "NY",
            "postal_code": "11692",
            "telephone_number": "718-945-7150",
            "fax_number": "718-945-2596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105-34 ROCKAWAY BOULEVARD",
            "city": "OZONE PARK",
            "state": "NY",
            "postal_code": "11417",
            "telephone_number": "718-945-7150",
            "fax_number": "718-945-2596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH P. ADDABBO FAMILY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-07",
        "last_updated": "2016-02-04",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "MARJORIE",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-945-7150",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NY",
            "license": "7003234R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00990152",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ozone Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.