Damian Family Care Centers, Inc.

Organization Active NPI Federally Qualified Health Center (FQHC) · Jamaica, NY

NPI 1487923595 · NPPES record last updated Jun 11, 2026

Key facts

NPI
1487923595
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
DAMIAN FAMILY CARE CENTERS, INC.
Practice address
89-56 162ND Street
Jamaica, NY 11432
Phone
(347) 505-7000
Fax
(347) 505-2500
NPI assigned
Dec 19, 2011
Organization subpart
No

Authorized official

Name
Kavanaugh Chandler, MD
Title
President & Ceo
Phone
(718) 657-1100

Other NPIs with the same Medicare PAC ID 11

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

Practitioners 70

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

View all 70

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY

Federally qualified health center certification: CCN 571827

Legal name
DAMIAN FAMILY CARE CENTERS, INC.
Doing business as
PROJECT SAMARITAN HEALTH SERVICES
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 12, 2022
Last certification
Jan 12, 2022
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
May 24, 2011 in NY
Enrollment address
8956 162ND St
Jamaica, NY 11432-5072

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 Director
Board Member
Jun 21, 2016
Peter Grisafi
Individual
Corporate Officer
Ceo/ President
Nov 1, 2013
Corporate Director
Ceo
Feb 29, 1996
W-2 Managing Employee
Ceo
Nov 1, 2013
Junnie E Campbell
Individual
Corporate Director
Chairperson
Jul 1, 2003
Arismendi Jimenez
Individual
Corporate Director
Board Member
Mar 21, 2017
Michael Degraffenreid
Individual
Corporate Director
Board Member
Sep 1, 2011
Cynthia Cortes
Individual
Corporate Director
Board Member
Oct 1, 2013
Idania Lopez Mercado
Individual
Corporate Director
Board Member
Aug 16, 2016
Gordon Siess
Individual
Corporate Officer
Cfo
Oct 8, 2020
Chinyere Eze-Nliam
Individual
Corporate Director
Board Member
Mar 29, 2016

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20220214001540 NY Part a Provider - Federally Qualified Health Center (FQHC) 6507849882 Practice locations: Jamaica, NY

National Provider Directory

Locations

599 Ralph Ave
Brooklyn, NY 11233
Phone (347) 501-6306

3411 Vernon Blvd
Long Island City, NY 11106
Phone (646) 505-2003

13 Hell Gate Cir
New York, NY 10035
Phone (212) 426-6633

500 8th Ave
Fl 3
New York, NY 10018
Phone (212) 904-1500

225 E 53rd St
Ofc 1
New York, NY 10022
Phone (212) 829-1200

Specialties & licenses

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

Addresses

Primary practice location

89-56 162ND Street
Jamaica, NY 11432

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
01690633MedicaidNY

Other names

  • Project Samaritan Health Services Doing business as

Other providers in Jamaica, NY

All providers in Jamaica, NY · Federally Qualified Health Center (FQHC) in New York

Sources for this page

Verify at the official NPI Registry.