NPIMap

Damian Family Care Centers, Inc.

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

NPI 1508955592 · NPPES record last updated Apr 27, 2026

Key facts

NPI
1508955592
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
License
7003246R (NY)
Legal business name
DAMIAN FAMILY CARE CENTERS, INC.
Practice address
137-50 Jamaica Avenue
Jamaica, NY 11435
Phone
(718) 298-5100
Fax
(718) 298-5130
NPI assigned
Oct 11, 2006
Organization subpart
No

Authorized official

Name
Peter Grisafi
Title
Ceo/President
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 77

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

View all 77

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in NY

Federally qualified health center certification: CCN 331942

Legal name
DAMIAN FAMILY CARE CENTERS, INC.
Doing business as
DAMIAN FAMILY CARE CENTERS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 19, 2004
Last certification
Jul 19, 2004
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Jun 1, 1999 in NY
Enrollment address
137-50 Jamaica Ave
Jamaica, NY 11435-3610

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		 Nov 1, 2013
W-2 Managing Employee Nov 1, 2013
Junnie E Campbell
Individual 		Corporate Director Jun 15, 2004
Arismendi Jimenez
Individual 		Corporate Director
Board Member		 Mar 21, 2017
Michael Degraffenreid
Individual 		Corporate Director Sep 1, 2011
Cynthia Cortes
Individual 		Corporate Director Oct 1, 2013
Idania Lopez Mercado
Individual 		Corporate Director
Board Member		 Aug 16, 2016
Gordon Siess
Individual 		Corporate Officer
Chief Financial Officer		 Oct 8, 2020
Chinyere Eze-Nliam
Individual 		Corporate Director
Board Member		 Mar 29, 2016

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040608001298 NY Part a Provider - Federally Qualified Health Center (FQHC) 6507849882 Practice locations: Jamaica, NY
O20151015001737 NY Part B Supplier - Clinic/Group Practice 6507849882 Receives reassigned benefits from 52 practitioners
Practice locations: Ronkonkoma, NY; Richmond Hill, NY; Rhinebeck, NY; New York, NY; Jamaica, NY; Ellenville, NY; Brooklyn, NY; Bronx, NY…

National Provider Directory

Locations

13020 89th Rd
Richmond Hill, NY 11418
Phone (718) 441-8913

Specialties & licenses

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

Addresses

Primary practice location

137-50 Jamaica Avenue
Jamaica, NY 11435

Mailing address

89-56 162ND Street
3Rd Floor
Jamiaca, NY 11432
Phone (718) 657-1100

Other identifiers

IdentifierTypeStateIssuer
01690633MedicaidNY

Other names

  • Project Samaritan Health Services Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 27, 2026.

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777248000000",
    "number": "1508955592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89-56 162ND STREET",
            "address_2": "3RD FLOOR",
            "city": "JAMIACA",
            "state": "NY",
            "postal_code": "11432",
            "telephone_number": "718-657-1100",
            "fax_number": "718-657-1870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137-50 JAMAICA AVENUE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "11435",
            "telephone_number": "718-298-5100",
            "fax_number": "718-298-5130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAMIAN FAMILY CARE CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A",
        "authorized_official_last_name": "GRISAFI",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "718-657-1100"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NY",
            "license": "7003246R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01690633",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Project Samaritan Health Services",
            "code": "3",
            "type": "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.