NPIMap

Organization Active NPI

Damian Family Care Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Brooklyn, NY
National Provider Identifier
1477909349
Registry record updated Jun 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
7003246R Issued in NY
Legal business name
DAMIAN FAMILY CARE CENTERS, INC.
Practice address
599 Ralph Ave
Brooklyn, NY 11233
Phone
(718) 581-5798
NPI assigned
May 10, 2016
Organization subpart
Yes
Parent organization
DAMIAN FAMILY CARE CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 11, 2026

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

Authorized official

Name
Mr. Kavanaugh Chandler, MD
Title
President/Ceo
Phone
(718) 657-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 7003246R NY Primary

Addresses

Primary practice location

599 Ralph Ave
Brooklyn, NY 11233

Mailing address

8956 162ND St FL 3
Jamaica, NY 11432-5072
Phone (718) 657-1100

Other names 1

  • RALPH AVENUE HEALTH CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220131002254 NY Part A Provider - Federally Qualified Health Center (FQHC) 6507849882 Practice locations: Brooklyn, NY

Federally qualified health center certification: CCN 571822

Legal name
DAMIAN FAMILY CARE CENTERS, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 6, 2022
Last certification
Jan 6, 2022
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 24, 2011 in NY
Enrollment address
599 Ralph Ave
Brooklyn, NY 11233-5113

Other NPIs with the same Medicare PAC ID 11

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

National Provider Directory

National Provider Directory
Tax ID family
Damian Family Care Ctr11 organizations share this tax ID, including this one
Part of
Damian Family Care Ctr

Other organizations with this tax ID 10

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

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
John Tavolacci Individual Corporate DirectorBoard Member Jun 21, 2016
Peter Grisafi Individual Corporate OfficerCeo/ President Nov 1, 2013
Corporate DirectorCeo Feb 29, 1996
W-2 Managing EmployeeCeo Nov 1, 2013
Junnie E Campbell Individual Corporate DirectorChairperson Jul 1, 2003
Arismendi Jimenez Individual Corporate DirectorBoard Member Mar 21, 2017
Michael Degraffenreid Individual Corporate DirectorBoard Member Sep 1, 2011
Cynthia Cortes Individual Corporate DirectorBoard Member Oct 1, 2013
Idania Lopez Mercado Individual Corporate DirectorBoard Member Aug 16, 2016
Gordon Siess Individual Corporate OfficerCfo Oct 8, 2020
Chinyere Eze-Nliam Individual Corporate DirectorBoard Member Mar 29, 2016

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1462838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781136000000",
    "number": "1477909349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8956 162ND ST FL 3",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114325072",
            "telephone_number": "718-657-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "599 RALPH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11233",
            "telephone_number": "718-581-5798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAMIAN FAMILY CARE CENTERS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DAMIAN FAMILY CARE CENTER, INC.",
        "enumeration_date": "2016-05-10",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A",
        "authorized_official_last_name": "CHANDLER",
        "authorized_official_first_name": "KAVANAUGH",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "718-657-1100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NY",
            "license": "7003246R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RALPH AVENUE HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "RALPH AVENUE HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.