Centerlight Healthcare, Inc.

Primary specialty

PACE Provider OrganizationTaxonomy code 251T00000X

Legal business name

CENTERLIGHT HEALTHCARE, INC.

Practice address

13665 37TH Ave
Flushing, NY 11354-4110

Phone

(833) 252-2737

NPI assigned

Dec 29, 2009

Organization subpart

No

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

Authorized official

Name

Erin Liberti

Title

VP. Provider Relations

Phone

(917) 828-7701

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Direct Total MAP Other name

Tax ID family

Centerlight Healthcare Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Centerlight Healthcare, Inc

  • Health Maintenance Organization
  • Flushing, NY
  • NPI 1528226610
  NPD tax ID

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

{
    "created_epoch": "1262044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725580800000",
    "number": "1194055939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13665 37TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113544110",
            "telephone_number": "833-252-2737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13665 37TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113544110",
            "telephone_number": "833-252-2737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERLIGHT HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-29",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A",
        "authorized_official_last_name": "LIBERTI",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "VP. PROVIDER RELATIONS",
        "authorized_official_telephone_number": "917-828-7701"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03171946",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Direct Total MAP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Angela Centeno Gavica, DO
• Jerry Noel Centeno, M.D.
• Center for Learning and Growth Health and Wellness Services, LLC
• Centerhealth Medical PLLC
• Centerlight Healthcare, Inc
• Centerlight Healthcare, Inc.
• Central Ipa Inc
• Central Radiology, PC
• Centum Physical Therapy PC
• Centurion Chiropractic PC

• PACE Provider Organization in Flushing, NY
• Providers in Flushing, NY by specialty
• PACE Provider Organization in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.