NPIMap

Organization Active NPI

The Institute for Family Health

  • Family Medicine Physician
  • Kingston, NY
National Provider Identifier
1477827624
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
THE INSTITUTE FOR FAMILY HEALTH
Practice address
1 Family Practice Dr
Kingston, NY 12401-6449
Phone
(845) 338-6400
Fax
(845) 339-7288
NPI assigned
Mar 6, 2012
Last updated
Apr 22, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
THE INSTITUTE FOR FAMILY HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Authorized official

Name
Eric Gayle, MD
Title
President and Ceo
Phone
(212) 633-0800

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1 Family Practice Dr
Kingston, NY 12401-6449

Mailing address

CL # 4655
PO Box 95000
Philadelphia, PA 19195-4655
Phone (845) 255-3435

Other identifiers 1

IdentifierTypeStateIssuer
00903700MedicaidNY

Other names 1

  • Family Practice Center of Kingston Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040417000313 NY Part B Supplier - Clinic/Group Practice 9234048588 Receives reassigned benefits from 337 practitioners
33 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: New York, NY; Bronx, NY; Brooklyn, NY; Hyde Park, NY; New Paltz, NY; Kingston, NY; Ellenville, NY
O20070419000115 NY Part A Provider - Federally Qualified Health Center (FQHC) 9234048588 2 other NPIs on this enrollment
Practice locations: Kingston, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1477827624. Details of each certification follow.

Federally qualified health center certification: CCN 331959

Legal name
THE INSTITUTE FOR FAMILY HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 5, 2007
Last certification
Jun 5, 2007
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
1 Family Practice Dr
Kingston, NY 12401-6449

Other NPIs on the same Medicare enrollment 33

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

View all 33

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2060433Family Practice Center of Kingston1 Family Practice Drive, Kingston, NY 12401Provider-performed microscopyMar 26, 2027

National Provider Directory

National Provider Directory
Tax ID family
Todd Mangum30 organizations share this tax ID, including this one
Part of
Todd Mangum

Other organizations with this tax ID 29

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

View all 29

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Leesa Hubbell Individual Corporate DirectorBoard Member Nov 1, 2025
Marsha Rimler Individual Corporate DirectorBoard Member Nov 1, 2025
Caroline Dicioccio Individual Corporate Officer Apr 1, 2019
Kathleen O'Donnell Individual Corporate DirectorBoard Member Aug 1, 2015
Steven Kelley Individual Corporate DirectorBoard Member Mar 19, 2010
Michael Blatchely Individual Corporate DirectorBoard Member Mar 1, 2013
Andrea Zakin-Amano Individual Corporate DirectorBoard Member Mar 1, 2013
Joseph Asubonteng Individual Corporate DirectorBoard Member Nov 3, 2010
Eric Gayle Individual Corporate OfficerPresident & Ceo Apr 1, 2025
W-2 Managing Employee Feb 28, 2024
Tina Goodrich Individual Corporate DirectorBoard Member Mar 9, 2011
Ollie Brown-Carrington Individual Corporate DirectorBoard Member Mar 24, 2003
Samuel Santiago Individual Corporate DirectorBoard Member Apr 6, 2011
Carole Furman Individual Corporate DirectorBoard Member Mar 1, 2013
Josephine Sanchez Individual Corporate DirectorVP of Business Development Feb 20, 2024
W-2 Managing EmployeeVP of Business Development Feb 20, 2024
Maribel Mercado Individual Corporate DirectorBoard Member Nov 1, 2025

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 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1330992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745280000000",
    "number": "1477827624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CL # 4655",
            "address_2": "PO BOX 95000",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191954655",
            "telephone_number": "845-255-3435",
            "fax_number": "845-256-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 FAMILY PRACTICE DR",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124016449",
            "telephone_number": "845-338-6400",
            "fax_number": "845-339-7288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE INSTITUTE FOR FAMILY HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE INSTITUTE FOR FAMILY HEALTH",
        "enumeration_date": "2012-03-06",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A",
        "authorized_official_last_name": "GAYLE",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "212-633-0800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00903700",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Practice Center of Kingston",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Kingston, NY

Sources for this page

Verify at the official NPI Registry.