NPIMap

Organization Active NPI

Urban Health Plan, Inc.

  • Federally Qualified Health Center (FQHC)
  • Elmhurst, NY
National Provider Identifier
1477043693
Registry record updated May 14, 2018
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
4510 94TH St
Elmhurst, NY 11373-2824
Phone
(347) 748-6115
NPI assigned
May 14, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2018

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

Authorized official

Name
Paloma Hernandez, PHD/MPH
Title
President and Ceo
Phone
(718) 589-2440

Specialties & licenses 1

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

Addresses

Primary practice location

4510 94TH St
Elmhurst, NY 11373-2824

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
02994952MedicaidNY

Other names 1

  • ELMHURST VOYAGES HIGH SCHOOL Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190207002854 NY Part A Provider - Federally Qualified Health Center (FQHC) 3173517281 Practice locations: Elmhurst, NY

Federally qualified health center certification: CCN 571169

Legal name
URBAN HEALTH PLAN INC
Doing business as
ELMHURST VOYAGES HIGH SCHOOL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 7, 2019
Last certification
Feb 7, 2019
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 1, 1978 in NY
Enrollment address
4510 94TH St
Elmhurst, NY 11373-2824

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

Other organizations with this tax ID 26

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

View all 26

Locations

4510 94th St
Elmhurst, NY 11373
Phone (347) 748-6115

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Paloma Hernandez Individual Corporate OfficerPresident and Ceo May 1, 1978
Corporate DirectorPresident and Ceo May 1, 1978
W-2 Managing EmployeePresident and Ceo May 1, 1978
Operational/Managerial ControlPresident and Ceo May 1, 1978
Elizabeth Alicea Individual Corporate DirectorBoard Member Sep 29, 2025
Rhynna Santos Individual Corporate DirectorChairperson of the Board Sep 26, 2019
Joan Rivera-Baker Individual Corporate DirectorSecretary of the Board Jan 1, 2009
Lorraine Marissa Gonzalez- Camastra Individual Corporate DirectorBoard Member Sep 29, 2025
Linda Baldwin Individual Corporate DirectorVice Chairperson of the Board Mar 23, 2009
Charles Gonzalez Individual Corporate DirectorBoard Member Jun 15, 1998
Edward S Butts Individual Corporate DirectorBoard Member Jan 1, 2011
Clifford Charles Individual Corporate DirectorTreasurer of the Board Mar 23, 2009
Oswaldo a Guzman Individual Corporate DirectorBoard Member Jan 1, 2013
Vonetta Dudley Individual Corporate DirectorBoard Member Jun 25, 2025
Abraham Hidalgo Individual Corporate DirectorBoard Member Sep 29, 2025

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": "1526256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526256000000",
    "number": "1477043693",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 94TH ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113732824",
            "telephone_number": "347-748-6115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "URBAN HEALTH PLAN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-14",
        "last_updated": "2018-05-14",
        "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",
        "authorized_official_credential": "PHD/MPH"
    },
    "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": "02994952",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ELMHURST VOYAGES HIGH SCHOOL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ELMHURST VOYAGES HIGH SCHOOL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elmhurst, NY

Sources for this page

Verify at the official NPI Registry.