NPIMap

Organization Active NPI

Union Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Bronx, NY
National Provider Identifier
1427371012
Registry record updated Mar 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
UNION COMMUNITY HEALTH CENTER, INC.
Practice address
4487 3Rd Ave
Bronx, NY 10457-1526
Phone
(718) 960-9465
Fax
(718) 960-3824
NPI assigned
Mar 10, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2018

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

Authorized official

Name
Mrs. Mary Hartnett, CFO
Title
Chief Financial Officer
Phone
(718) 960-9465

Specialties & licenses 1

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

Addresses

Primary practice location

4487 3Rd Ave
Bronx, NY 10457-1526

Mailing address

4487 3Rd Ave
Bronx, NY 10457-1526
Phone (718) 960-9465

Other identifiers 1

IdentifierTypeStateIssuer
02064111MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121022000256 NY Part A Provider - Federally Qualified Health Center (FQHC) 4486545266 Practice locations: Bronx, NY

Federally qualified health center certification: CCN 331010

Legal name
UNION COMMUNITY HEALTH CENTER INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 21, 2010
Last certification
Oct 21, 2010
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 19, 1999 in NY
Enrollment address
4487 3Rd Ave
Bronx, NY 10457-1526
Related CCNs
331984

Facilities connected through Provider of Services related, parent or unit certification numbers.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Mary Hartnett Individual Corporate OfficerCeo/Board of Directors Jan 26, 2006 100%
W-2 Managing EmployeeCfo Jan 26, 2006 100%
Anne Spellman Individual Corporate OfficerCoo/Board of Directors Jan 26, 2006 100%
W-2 Managing EmployeeChief Operating Officer Jan 26, 2006

Other NPIs with the same Medicare PAC ID 7

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

Practitioners 49

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

View all 49

NPI Registry JSON

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

{
    "created_epoch": "1268179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522195200000",
    "number": "1427371012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4487 3RD AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104571526",
            "telephone_number": "718-960-9465",
            "fax_number": "718-960-3824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4487 3RD AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104571526",
            "telephone_number": "718-960-9465",
            "fax_number": "718-960-3824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNION COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-10",
        "last_updated": "2018-03-28",
        "status": "A",
        "authorized_official_last_name": "HARTNETT",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "718-960-9465",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02064111",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.