NPIMap

Organization Active NPI

Care for the Homeless

  • Federally Qualified Health Center (FQHC)
  • Bronx, NY
National Provider Identifier
1306182076
Registry record updated Apr 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
70000279R Issued in NY
Legal business name
CARE FOR THE HOMELESS
Practice address
691 E 138TH St
Bronx, NY 10454-3307
Phone
(718) 993-8900
Fax
(212) 366-1773
NPI assigned
Dec 27, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2015

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

Authorized official

Name
Debbian Fletcher Blake
Title
Assistant Executive Director
Phone
(212) 366-4459

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 70000279R NY Primary

Addresses

Primary practice location

691 E 138TH St
Bronx, NY 10454-3307

Mailing address

30 E 33Rd St
New York, NY 10016-5337
Phone (212) 366-4459

Other names 1

  • Care For The Homeless Jackson Avenue Family Residence Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120111000358 NY Part A Provider - Federally Qualified Health Center (FQHC) 9830240332 Practice locations: Bronx, NY
O20190129003068 NY Part B Supplier - Clinic/Group Practice 9830240332 Receives reassigned benefits from 28 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bronx, NY; Brooklyn, NY

Federally qualified health center certification: CCN 571901

Legal name
CARE FOR THE HOMELESS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 21, 2025
Last certification
Mar 21, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
691 E 138TH St
Bronx, NY 10454-3307

Federally qualified health center certification: CCN 331145

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
CARE FOR THE HOMELESS 9367
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 12, 2015
Last certification
May 12, 2015
Ownership / control type
For profit – corporation
Facility address
691 East 138TH Street
Bronx, NY 10454

Other NPIs with the same Medicare PAC ID 11

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

Other NPIs on the same Medicare enrollment 10

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

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Fulvia Frazier Individual Corporate OfficerBoard Member Jan 1, 2023
Corporate DirectorBoard Member Jan 1, 2023
Rakesh Chandra Individual Corporate OfficerBoard Member Jan 1, 2024
Corporate DirectorBoard Member Jan 1, 2024
Timothy Karcher Individual Corporate OfficerBoard Member Jan 1, 2014
Corporate DirectorBoard Member Jan 1, 2014
Lloyd E Bailey Individual Corporate OfficerChair of Cqi May 1, 2016
Corporate DirectorChair of Cqi May 1, 2016
Philip Malebranche Individual Corporate OfficerChair of Policy & Advocacy Jan 1, 2018
Corporate DirectorChair of Policy & Advocacy Jan 1, 2018
Allen Rumanyika Individual Corporate OfficerBoard Treasurer Jan 1, 2021
Corporate DirectorBoard Treasurer Jan 1, 2021
Janardhan Cadambi Individual Corporate OfficerChair of Audit & Compliance Jan 1, 2023
Corporate DirectorChair of Audit & Compliance Jan 1, 2023
Frances a Melendez Individual Corporate OfficerBoard Member Jan 1, 2023
Corporate DirectorBoard Member Jan 1, 2023
Judy Tabak Individual Corporate OfficerBoard Secretary Jan 1, 2020
Corporate DirectorBoard Secretary Jan 1, 2020
Marian Haas Individual Corporate OfficerBoard Vice Chair Jan 1, 2023
Corporate DirectorBoard Vice Chair Jan 1, 2023
Kai-Chun Chue Individual Corporate OfficerChief Financial Officer Jan 1, 2022
Corporate DirectorChief Financial Officer Jan 1, 2022
W-2 Managing Employee Jan 1, 2022
Jane Parker Individual Corporate OfficerBoard Member Jan 1, 2019
Corporate DirectorBoard Member Jan 1, 2019
Jonathan Dwayne Santos-Ramos Individual Corporate OfficerChief Program Officer Jun 5, 2023
Corporate DirectorChief Program Officer Jun 5, 2023
George Nashak Individual Corporate OfficerPresident and Ceo Jan 1, 2017
Corporate DirectorPresident and Ceo Jan 1, 2017
Surjit Chana Individual Corporate OfficerBoard Chair Jan 1, 2017
Corporate DirectorBoard Chair Jan 1, 2017
Delise Dupont Blenman Individual Corporate OfficerBoard Member Jan 1, 2013
Corporate DirectorBoard Member Jan 1, 2013
Harry K Thomas Individual Corporate OfficerChair of Development Communications Jan 1, 2019
Corporate DirectorChair of Development Communications Jan 1, 2019
Robert Heckart Individual Corporate OfficerChair of Nominations & Governance Jan 1, 2019
Corporate DirectorChair of Nominations & Governance Jan 1, 2019
Grigor Licul Individual Corporate OfficerBoard Member Jan 1, 2014
Corporate DirectorBoard Member Jan 1, 2014
Amanda Fialk Individual Corporate OfficerBoard Member Jan 1, 2023
Corporate DirectorBoard Member Jan 1, 2023

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1356566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429056000000",
    "number": "1306182076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 E 33RD ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165337",
            "telephone_number": "212-366-4459",
            "fax_number": "212-366-1773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "691 E 138TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104543307",
            "telephone_number": "718-993-8900",
            "fax_number": "212-366-1773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARE FOR THE HOMELESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-27",
        "last_updated": "2015-04-15",
        "status": "A",
        "authorized_official_last_name": "FLETCHER BLAKE",
        "authorized_official_first_name": "DEBBIAN",
        "authorized_official_title_or_position": "ASSISTANT EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "212-366-4459"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NY",
            "license": "70000279R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Care For The Homeless Jackson Avenue Family Residence",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.