NPIMap

Organization Active NPI

Community Healthcare Network, Inc

Doing business as Ohio

  • Federally Qualified Health Center (FQHC)
  • Jamaica, NY
National Provider Identifier
1508222522
Registry record updated May 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
7002119R Issued in NY
Legal business name
COMMUNITY HEALTHCARE NETWORK, INC
Doing business as
Ohio
Practice address
9704 Sutphin Blvd
Jamaica, NY 11435-4721
Phone
(718) 657-7088
Fax
(718) 657-7092
NPI assigned
Jan 6, 2016
Last updated
May 11, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2016

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

Authorized official

Name
Mr. Alan J. Wengrofsky
Title
Vice President of Finance and Cfo
Phone
(212) 545-2481

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 7002119R NY Primary

Addresses

Primary practice location

9704 Sutphin Blvd
Jamaica, NY 11435-4721

Mailing address

60 Madison Ave
5TH Floor
New York, NY 10010-1600
Phone (212) 545-2439

Other identifiers 1

IdentifierTypeStateIssuer
000695941MedicaidNY

Other names 1

  • Ohio Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040322000987 NY Part B Supplier - Clinic/Group Practice 7416855143 Receives reassigned benefits from 108 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: New York, NY; Long Island City, NY; Jamaica, NY; Brooklyn, NY; Bronx, NY

Other NPIs on the same Medicare enrollment 16

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

View all 16

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1452038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462924800000",
    "number": "1508222522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 MADISON AVE",
            "address_2": "5TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100101600",
            "telephone_number": "212-545-2439",
            "fax_number": "646-312-0481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9704 SUTPHIN BLVD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114354721",
            "telephone_number": "718-657-7088",
            "fax_number": "718-657-7092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTHCARE NETWORK, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-06",
        "last_updated": "2016-05-11",
        "status": "A",
        "authorized_official_last_name": "WENGROFSKY",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE AND CFO",
        "authorized_official_telephone_number": "212-545-2481",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NY",
            "license": "7002119R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000695941",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ohio",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.