NPIMap

Organization Active NPI

Bronxcare Dr. Martin Luther King Jr. Health Center

  • Federally Qualified Health Center (FQHC)
  • Bronx, NY
National Provider Identifier
1376898908
Registry record updated May 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
7000212R Issued in NY
Legal business name
BRONXCARE DR. MARTIN LUTHER KING JR. HEALTH CENTER
Practice address
321 E Tremont Ave
Bronx, NY 10457
Phone
(718) 901-8600
Fax
(718) 293-1475
NPI assigned
Jul 19, 2012
Organization subpart
Yes
Parent organization
DR MARTIN LUTHER KING JR HEALTH CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 31, 2018

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

Authorized official

Name
Mr. Victor G Demarco, CPA
Title
Senior VP-Chief Financial Officer
Phone
(718) 901-8600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 7000212R NY Primary

Addresses

Primary practice location

321 E Tremont Ave
Bronx, NY 10457

Mailing address

1276 Fulton Ave
Bronx, NY 10456-3402
Phone (718) 901-8600

Other identifiers 2

IdentifierTypeStateIssuer
00244573MedicaidNY
W0437OtherNYBLUE CROSS

Other names 1

  • Bronx Care Dr. Martin Luther King Jr. Health Center Other name

National Provider Directory

National Provider Directory
Tax ID family
Martin L King HLTH Ctr7 organizations share this tax ID, including this one
Part of
Martin L King HLTH Ctr

Other organizations with this tax ID 6

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

Locations

1067 Ogden Ave
Bronx, NY 10452
Phone (718) 466-6072

1690 Bryant Ave
Bronx, NY 10460
Phone (718) 901-8911

1591 Fulton Ave
Bronx, NY 10457
Phone (718) 716-4585

853 Tiffany St
Bronx, NY 10459
Phone (718) 860-6169

Practitioners & affiliated clinicians

Practitioners 5

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": "1342656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527724800000",
    "number": "1376898908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 FULTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563402",
            "telephone_number": "718-901-8600",
            "fax_number": "718-293-1475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 E TREMONT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10457",
            "telephone_number": "718-901-8600",
            "fax_number": "718-293-1475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRONXCARE DR. MARTIN LUTHER KING JR. HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DR MARTIN LUTHER KING JR HEALTH CENTER INC",
        "enumeration_date": "2012-07-19",
        "last_updated": "2018-05-31",
        "status": "A",
        "authorized_official_last_name": "DEMARCO",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "SENIOR VP-CHIEF  FINANCIAL OFFICER",
        "authorized_official_telephone_number": "718-901-8600",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NY",
            "license": "7000212R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00244573",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "W0437",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bronx Care Dr. Martin Luther King Jr. Health Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Bronx Care Dr. Martin Luther King Jr. Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2018; 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.