NPIMap

Organization Active NPI

Community Healthcare Network Inc

  • Federally Qualified Health Center (FQHC)
  • Brooklyn, NY
National Provider Identifier
1154498822
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTHCARE NETWORK INC
Practice address
999 Blake Ave
Brooklyn, NY 11208-3535
Phone
(718) 277-8303
Fax
(718) 277-4795
NPI assigned
Nov 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Authorized official

Name
Alan J. Wengrofsky
Title
Cfo
Phone
(212) 545-2481

Specialties & licenses 1

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

Addresses

Primary practice location

999 Blake Ave
Brooklyn, NY 11208-3535

Mailing address

44 W 28TH Street
Floor 5
New York, NY 10001-4212
Phone (212) 545-2409

Other names 1

  • Dr. Betty Shabazz Health Center Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040322000987 NY Part B Supplier - Clinic/Group Practice 7416855143 Receives reassigned benefits from 108 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: New York, NY; Long Island City, NY; Jamaica, NY; Brooklyn, NY; Bronx, NY
O20040709000876 NY Part A Provider - Federally Qualified Health Center (FQHC) 7416855143 Practice locations: Brooklyn, NY

Federally qualified health center certification: CCN 331944

Legal name
COMMUNITY HEALTHCARE NETWORK INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 7, 2004
Last certification
Sep 7, 2004
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 18, 1978 in NY
Enrollment address
999 Blake Ave
Brooklyn, NY 11208-3535

Other NPIs with the same Medicare PAC ID 12

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

Other NPIs on the same Medicare enrollment 16

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

View all 16

National Provider Directory

National Provider Directory

Locations

94 Manhattan Ave
Ste 98
Brooklyn, NY 11206

1167 Nostrand Ave
Brooklyn, NY 11225
Phone (718) 778-0198

2581 Atlantic Ave
Fl 1
Brooklyn, NY 11207
Phone (718) 495-6700

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Edwidge J Thomas Individual Corporate OfficerBoard Member May 20, 2021
Corporate DirectorBoard Member May 20, 2021
Caroline Dorsen Individual Corporate OfficerBoard Member Oct 1, 2015
Corporate DirectorBoard Member Oct 1, 2015
Robert M. Hayes Individual Corporate OfficerPresident and Ceo Jan 20, 2015
Corporate DirectorPresident and Ceo Jan 20, 2015
Alan J Wengrofsky Individual Corporate Officer Oct 27, 2011
Corporate Director Oct 1, 2007
W-2 Managing Employee Oct 1, 2007
Taisha L Benjamin Individual Corporate OfficerChief Medical Officer Aug 21, 2014
Denise Gordon Individual Corporate DirectorBoard Member Dec 1, 2016
Elizabeth Krob-Kellner Individual Corporate Officer Oct 27, 2011
Corporate Director Aug 12, 2004
Roger Platt Individual Corporate DirectorBoard Member Dec 1, 2021
Richard Barasch Individual Corporate DirectorBoard Member Dec 1, 2023
June E Niklus Individual Corporate Officer Oct 27, 2011
Corporate Director Oct 1, 2007
Kathleen O'Neill Individual Corporate DirectorBoard Member Dec 1, 2020
Rhonda Kotelchuck Individual Corporate OfficerBoard Member Nov 5, 2018
Corporate DirectorBoard Member Nov 5, 2018
Kristin L Manzolillo Individual Corporate OfficerSecretary May 10, 2018
Corporate DirectorSecretary May 10, 2018
Donna E Anderson Individual Corporate Officer Oct 27, 2011
Corporate Director Aug 12, 2004
Harlem J. Gunness Individual Corporate OfficerBoard Member May 1, 2019
Corporate DirectorBoard Member May 1, 2019
Greta Elysee Individual Corporate Officer Oct 27, 2011
Corporate Director Jul 19, 2004
Curtis Young Individual Corporate OfficerBoard Member Aug 19, 2021
Corporate DirectorBoard Member Aug 19, 2021
Josephine Diaz Individual Corporate Officer Oct 27, 2011
Corporate Director Oct 1, 2007

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757635200000",
    "number": "1154498822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 W 28TH STREET",
            "address_2": "FLOOR 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100014212",
            "telephone_number": "212-545-2409",
            "fax_number": "646-312-0481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 BLAKE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112083535",
            "telephone_number": "718-277-8303",
            "fax_number": "718-277-4795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTHCARE NETWORK INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A",
        "authorized_official_last_name": "WENGROFSKY",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "212-545-2481"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Betty Shabazz Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.