NPIMap

Organization Active NPI

Paterson Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Paterson, NJ
National Provider Identifier
1487694832
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
71672 Issued in NJ
Legal business name
PATERSON COMMUNITY HEALTH CENTER, INC.
Practice address
32 Clinton St
Paterson, NJ 07522-1775
Phone
(973) 790-6594
Fax
(973) 790-7703
NPI assigned
Jun 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Authorized official

Name
Mr. Bevan K Baker, FACHE
Title
Ceo
Phone
(973) 790-6594

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 71672 NJ Primary
Federally Qualified Health Center (FQHC) 261QF0400X 82304 NJ

Addresses

Primary practice location

32 Clinton St
Paterson, NJ 07522-1775

Mailing address

32 Clinton St
Paterson, NJ 07522-1775
Phone (973) 790-6594

Other identifiers 2

IdentifierTypeStateIssuer
0044342MedicaidNJ
0044300MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20081120000788 NJ Part A Provider - Federally Qualified Health Center (FQHC) 7315007333 Practice locations: Paterson, NJ
O20140502000161 NJ Part B Supplier - Clinic/Group Practice 7315007333 Receives reassigned benefits from 14 practitioners
Practice locations: Paterson, NJ
O20251029002512 NJ Part A Provider - Federally Qualified Health Center (FQHC) 7315007333 Practice locations: Paterson, NJ

Federally qualified health center certification: CCN 311810

Legal name
PATERSON COMMUNITY HEALTH CENTER INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 1, 1992
Last certification
Jan 1, 1992
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Apr 14, 1981 in NJ
Enrollment address
32 Clinton Street
Paterson, NJ 75221775

Federally qualified health center certification: CCN 311021

Legal name
PATERSON COMMUNITY HEALTH CENTER INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 3, 2025
Last certification
Sep 3, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
32 Clinton St
Paterson, NJ 75221775

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Paterson Community Health Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

227 Broadway
Paterson, NJ 07501
Phone (973) 278-2600

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Mary Monroe Individual Corporate Director Jan 1, 2005
Debora Laughinghouse Walcott Individual Corporate Director Nov 30, 1998
Corporate OfficerChief Financial Officer Nov 30, 1998
W-2 Managing EmployeeChief Financial Officer Nov 30, 1998
Mary Wheeler Individual Corporate Director Jan 1, 2000
Jose Moore Individual Corporate Director Jan 1, 2014
Joseph Barbieri Individual Corporate Director Jan 1, 1996
Anthony Powell Individual Corporate Director Jan 1, 2004
Helen Kennedy Individual Corporate Director Jan 1, 1994
Mary Garner Individual Corporate OfficerCeo Feb 4, 1991
Corporate Director Feb 4, 1991
W-2 Managing Employee Feb 4, 1991
Sharon Easton Individual Corporate Director Apr 15, 2011
Bevan Keith Baker Individual Corporate OfficerChief Executive Officer Mar 3, 2025
W-2 Managing EmployeeChief Executive Officer Mar 3, 2025

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755648000000",
    "number": "1487694832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 CLINTON ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075221775",
            "telephone_number": "973-790-6594",
            "fax_number": "973-790-7703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 CLINTON ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075221775",
            "telephone_number": "973-790-6594",
            "fax_number": "973-790-7703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATERSON COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "BEVAN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "973-790-6594",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "FACHE"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NJ",
            "license": "71672",
            "primary": true
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NJ",
            "license": "82304",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0044342",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0044300",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paterson, NJ

Sources for this page

Verify at the official NPI Registry.