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
Last updated
Feb 4, 2016By the provider in NPPES
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, PHDNPI 1801389697
Title
Ceo
Phone
(718) 945-7150

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 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

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1134476443. Details of each certification follow.

  • CCN 331122 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 331122

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
JOSEPH P ADDABBO FAMILY HLTH CTR
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 17, 2014
Last certification
Oct 17, 2014
Ownership / control type
For profit – corporation
Facility address
105-34 Rockaway Blvd
Ozone Park, NY 11417

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

Practitioners & affiliated clinicians

Practitioners 61

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 61

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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ozone Park, NY

Sources for this page

Verify at the official NPI Registry.