NPIMap

Organization Active NPI

Harmony Health Care Long Island

  • Federally Qualified Health Center (FQHC)
  • Freeport, NY
National Provider Identifier
1578039418
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HARMONY HEALTH CARE LONG ISLAND
Practice address
50 S Brookside Ave
Freeport, NY 11520-3144
Phone
(516) 623-3600
NPI assigned
Oct 18, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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

Authorized official

Name
David Neimiroff, LCSW
Title
President, Ceo
Phone
(516) 546-4198

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Student Health Clinic/Center 261QS1000X

Addresses

Primary practice location

50 S Brookside Ave
Freeport, NY 11520-3144

Mailing address

1600 Stewart Ave Ste 300
Westbury, NY 11590-6611
Phone (516) 396-0187

Other identifiers 2

IdentifierTypeStateIssuer
06775328MedicaidNY
571816OtherNYMEDICARE

Other names 1

  • Long Island FQHC,Inc. Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210827002014 NY Part A Provider - Federally Qualified Health Center (FQHC) 5991970535 Practice locations: Freeport, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1578039418. Details of each certification follow.

Federally qualified health center certification: CCN 571816

Legal name
HARMONY HEALTH CARE LONG ISLAND
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 27, 2021
Last certification
Aug 27, 2021
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Sep 15, 2009 in NY
Enrollment address
50 S Brookside Ave
Freeport, NY 11520-3144

Other NPIs with the same Medicare PAC ID 9

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

National Provider Directory

National Provider Directory
Tax ID family
Harmony Health Care Long Island11 organizations share this tax ID, including this one

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 10

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

NameRoleSinceShare
Savitree Pestano Individual W-2 Managing EmployeeChief Financial Officer Mar 1, 2021
Stafford Byers Individual Corporate OfficerBoard Finance Committee Chair Jul 1, 2018
Corporate DirectorBoard Finance Committee Chair Jul 1, 2018
Evelyn Lamoureux Individual Corporate OfficerBoard Member Jul 1, 2018
Gwen O'Shea Individual Corporate OfficerBoard Member Jul 1, 2018
Lance Elder Individual Corporate OfficerBoard Member Jul 1, 2018
Frank Piscetelli Individual Corporate DirectorBoard Chair Jul 10, 2018
Ann Hickson Individual Corporate OfficerBoard Secretary Jul 1, 2018
Elizabeth Rouse Individual Corporate OfficerBoard Member Jul 1, 2018
Jessica Sparrow Individual Corporate OfficerBoard Member Jul 1, 2018
David a Nemiroff Individual Corporate DirectorChief Executive Officer/President Jul 1, 2018

NPI Registry JSON

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

{
    "created_epoch": "1539820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707868800000",
    "number": "1578039418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 STEWART AVE STE 300",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115906611",
            "telephone_number": "516-396-0187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 S BROOKSIDE AVE",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115203144",
            "telephone_number": "516-623-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARMONY HEALTH CARE LONG ISLAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-18",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A",
        "authorized_official_last_name": "NEIMIROFF",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT, CEO",
        "authorized_official_telephone_number": "516-546-4198",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06775328",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "571816",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Long Island FQHC,Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Freeport, NY

Sources for this page

Verify at the official NPI Registry.