NPIMap

Organization Active NPI

Urban Health Plan, Inc.

  • Federally Qualified Health Center (FQHC)
  • Bronx, NY
National Provider Identifier
1467857433
Registry record updated Aug 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
URBAN HEALTH PLAN, INC.
Practice address
3209 3Rd Ave
Bronx, NY 10451
Phone
(347) 284-0203
Fax
(718) 993-5684
NPI assigned
Nov 3, 2014
Organization subpart
Yes
Parent organization
BORICUA COMMUNITY HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 12, 2015

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

Authorized official

Name
Paloma Hernandez
Title
President and Ceo
Phone
(718) 589-2440

Specialties & licenses 1

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

Addresses

Primary practice location

3209 3Rd Ave
Bronx, NY 10451

Mailing address

1065 Southern Blvd
Bronx, NY 10459-2417
Phone (718) 589-2440

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150811003564 NY Part A Provider - Federally Qualified Health Center (FQHC) 3173517281 Practice locations: Bronx, NY

Federally qualified health center certification: CCN 331155

Legal name
URBAN HEALTH PLAN INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 12, 2015
Last certification
Aug 12, 2015
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 21, 1974 in NY
Enrollment address
3209 3Rd Ave
Bronx, NY 10451-4203

Other NPIs with the same Medicare PAC ID 24

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

View all 24

National Provider Directory

National Provider Directory
Tax ID family
Urban Health Plan Inc27 organizations share this tax ID, including this one
Part of
Urban Health Plan Inc

Other organizations with this tax ID 26

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

View all 26

Locations

3209 3rd Ave
Bronx, NY 10451
Phone (347) 284-0203

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Frank Estrada Individual Corporate DirectorBoard Member Mar 23, 2009
Paloma Hernandez Individual Corporate OfficerPresident and Ceo Jun 21, 1974
Corporate DirectorPresident and Ceo Jun 21, 1974
W-2 Managing EmployeePresident and Ceo Jun 21, 1974
Heroilda Vega Individual Corporate DirectorBoard Member Jan 1, 1990
Rhynna Santos Individual Corporate DirectorBoard Member Sep 26, 2019
Joan Rivera-Baker Individual Corporate DirectorBoard Member Jan 1, 2009
Linda Baldwin Individual Corporate DirectorBoard Member Mar 23, 2003
Charles Gonzalez Individual Corporate DirectorBoard Member Jan 1, 1990
Edward S Butts Individual Corporate DirectorBoard Member Jan 1, 2011
Clifford Charles Individual Corporate DirectorBoard Member/Treasurer Mar 23, 2009
Oswaldo a Guzman Individual Corporate DirectorBoard Member Jan 1, 2013
Howard Hinestroza Individual Corporate DirectorBoard Member Oct 27, 2016
Michelle Carr Individual Corporate DirectorBoard Member/Secretary Jan 1, 2001
Yoselin Genao Individual Corporate DirectorBoard Member Nov 15, 2016

Owners & managing parties with NPI records 1

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

NPI Registry JSON

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

{
    "created_epoch": "1414972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439337600000",
    "number": "1467857433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 SOUTHERN BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104592417",
            "telephone_number": "718-589-2440",
            "fax_number": "718-991-4516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3209 3RD AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10451",
            "telephone_number": "347-284-0203",
            "fax_number": "718-993-5684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "URBAN HEALTH PLAN, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BORICUA COMMUNITY HEALTH CENTER",
        "enumeration_date": "2014-11-03",
        "last_updated": "2015-08-12",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "PALOMA",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "718-589-2440"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.