NPIMap

Organization Active NPI

City of New York Office of Payroll Administration

  • State or Local Public Health Clinic/Center
  • New York, NY
National Provider Identifier
1174570253
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X
Legal business name
CITY OF NEW YORK OFFICE OF PAYROLL ADMINISTRATION
Practice address
160 West 100TH Street
Nycdohmh Riverside DHC
New York, NY 10025-5145
Phone
(212) 280-9730
Fax
(212) 280-9297
NPI assigned
May 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Authorized official

Name
Janet Ellis
Title
Director of Patient Billing
Phone
(347) 396-6299

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
State or Local Public Health Clinic/Center 261QP0905X Primary

Addresses

Primary practice location

160 West 100TH Street
Nycdohmh Riverside DHC
New York, NY 10025-5145

Mailing address

42-09 28TH Street CN-48
Long Island City, NY 11101-4132
Phone (347) 396-6299

Other identifiers 1

IdentifierTypeStateIssuer
00247636MedicaidNY

Other names 1

  • NYCDOHMH Riverside District H Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040406001483 NY Part B Supplier - Clinic/Group Practice 9739172644 Receives reassigned benefits from 69 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Staten Island, NY; New York, NY; Long Island City, NY; Jamaica, NY; Jackson Heights, NY; Brooklyn, NY; Bronx, NY

Other NPIs on the same Medicare enrollment 15

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

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Rochelle Cherry46 organizations share this tax ID, including this one

Other organizations with this tax ID 45

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

View all 45

Locations

160 W 100th St
New York, NY 10025
Phone (646) 364-0786

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695859200000",
    "number": "1174570253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42-09 28TH STREET CN-48",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111014132",
            "telephone_number": "347-396-6299",
            "fax_number": "347-396-6367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 WEST 100TH STREET",
            "address_2": "NYCDOHMH RIVERSIDE DHC",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100255145",
            "telephone_number": "212-280-9730",
            "fax_number": "212-280-9297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF NEW YORK OFFICE OF PAYROLL ADMINISTRATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "DIRECTOR OF PATIENT BILLING",
        "authorized_official_telephone_number": "347-396-6299"
    },
    "taxonomies": [
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00247636",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NYCDOHMH Riverside District H",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NYCDOHMH Riverside District H",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; 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.