NPIMap

Organization Active NPI

Oda Primary Health Care Network, Inc.

  • Primary Care Clinic/Center
  • Brooklyn, NY
National Provider Identifier
1609275205
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
7001254R Issued in NY
Legal business name
ODA PRIMARY HEALTH CARE NETWORK, INC.
Practice address
432 Bedford Ave
Brooklyn, NY 11249-6588
Phone
(718) 387-2408
Fax
(718) 387-9222
NPI assigned
Aug 19, 2014
Organization subpart
Yes
Parent organization
ODA PRIMARY HEALTH CARE NETWORK, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Authorized official

Name
Joseph Deutsch
Title
Ceo
Phone
(718) 260-4600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 7001254R NY Primary

Addresses

Primary practice location

432 Bedford Ave
Brooklyn, NY 11249-6588

Mailing address

14 Heyward St
Brooklyn, NY 11249-7823
Phone (718) 260-4600

Other names 1

  • ODA Quality Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141020000631 NY Part A Provider - Federally Qualified Health Center (FQHC) 8729123815 Practice locations: Brooklyn, NY

Federally qualified health center certification: CCN 331123

Legal name
ODA PRIMARY HEALTH CARE NETWORK INC
Doing business as
ODA QUALITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 23, 2014
Last certification
Oct 23, 2014
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 29, 1974 in NY
Enrollment address
432 Bedford Ave
Brooklyn, NY 11249-6588
Related CCNs
331834

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 10

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

National Provider Directory

National Provider Directory
Tax ID family
Robert B Krausz14 organizations share this tax ID, including this one
Part of
Robert B Krausz

Other organizations with this tax ID 13

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

View all 13

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Issac a Katz Individual Corporate DirectorBoard Member Mar 1, 2003
Louis Kestenbaum Individual Corporate DirectorBoard President Feb 1, 2008
Aron Engel Individual Corporate DirectorBoard Member May 1, 2010
Christina Chopra Individual W-2 Managing EmployeePayor Relations Specialist Aug 20, 2014
Akiva Kobre Individual Corporate DirectorBoard Member Nov 1, 2013
Chavie Lieberman Individual Corporate DirectorBoard Member Jan 1, 1992
Rose Rosenfeld Individual Corporate OfficerChief Financial Officer Jun 3, 2015
Joseph Deutsch Individual Corporate OfficerCeo Jan 7, 2013
Moshe Friedman Individual Corporate DirectorBoard Member Dec 1, 2009
Naftali Ausch Individual Corporate DirectorBoard Member Dec 31, 1988
Naftali Horowitz Individual Corporate DirectorBoard Member Mar 1, 2003
David Hurwitz Individual Corporate DirectorBoard Member Mar 1, 2003
Chaya Malik Individual W-2 Managing EmployeeSpecial Projects Assistant Aug 20, 2014
Abraham Friedlander Individual Corporate DirectorBoard Member Nov 1, 1991

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1408406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641254400000",
    "number": "1609275205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 HEYWARD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112497823",
            "telephone_number": "718-260-4600",
            "fax_number": "718-852-0867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "432 BEDFORD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112496588",
            "telephone_number": "718-387-2408",
            "fax_number": "718-387-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODA PRIMARY HEALTH CARE NETWORK, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ODA PRIMARY HEALTH CARE NETWORK, INC.",
        "enumeration_date": "2014-08-19",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A",
        "authorized_official_last_name": "DEUTSCH",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-260-4600"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NY",
            "license": "7001254R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ODA Quality Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.