NPIMap

Organization Active NPI

Whitman Ingersoll Farragut Health Center

  • Federally Qualified Health Center (FQHC)
  • Brooklyn, NY
National Provider Identifier
1619366978
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
7001250R Issued in NY
Legal business name
WHITMAN INGERSOLL FARRAGUT HEALTH CENTER
Doing business as
Whitman Ingersoll Farragut Health Center
Practice address
297 Myrtle Ave
Brooklyn, NY 11205-2901
Phone
(718) 596-8000
Fax
(718) 596-8935
NPI assigned
Jan 9, 2015
Last updated
Nov 10, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
BROOKLYN PLAZA MEDICAL CENTER, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 10, 2025

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

Authorized official

Name
Sylvia Richardson
Title
Revenue Mangaer
Phone
(718) 596-9800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 7001250R NY Primary

Addresses

Primary practice location

297 Myrtle Ave
Brooklyn, NY 11205-2901

Mailing address

650 Fulton St
Brooklyn, NY 11217-1517
Phone (718) 596-9800

Other identifiers 1

IdentifierTypeStateIssuer
1619366978MedicaidNY

Other names 1

  • Whitman Ingersoll Farragut Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170503000192 NY Part B Supplier - Clinic/Group Practice 7113961178 Receives reassigned benefits from 15 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Brooklyn, NY
O20191120002428 NY Part A Provider - Federally Qualified Health Center (FQHC) 7113961178 Practice locations: Brooklyn, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1619366978. Details of each certification follow.

Federally qualified health center certification: CCN 571192

Legal name
WHITMAN INGERSOLL FARRAGUT HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 31, 2019
Last certification
Dec 31, 2019
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
297 Myrtle Ave
Brooklyn, NY 11205-2901

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Brooklyn Plaza Medical Center Inc5 organizations share this tax ID, including this one
Part of
Brooklyn Plaza Medical Center Inc

Other organizations with this tax ID 4

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

Locations

297 Myrtle Ave
Brooklyn, NY 11205
Phone (718) 596-8000

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
George Wong Individual Corporate DirectorBoard Member Oct 12, 2006
Sylvia Richardson Individual W-2 Managing EmployeeDirector of Revenue Management Jun 1, 2017
John Chaney Individual Corporate DirectorBoard Member Mar 15, 2011
Rolando Pagan Individual Corporate DirectorBoard Member May 13, 2013
Stevenson Dunn Individual Corporate DirectorBoard Member Mar 19, 2019
Esteen Ladsen-Barnes Individual Corporate DirectorBoard Member May 20, 2014
Doreen Cooper Individual Corporate DirectorBoard Member Jul 9, 2006
Shirley Luck Individual Corporate DirectorBoard Member Nov 7, 2008
Theresa Holmes-Simmons Individual Corporate DirectorBoard Member Nov 7, 2008
Caleb Terry Individual Corporate OfficerChief Compliance Officer Oct 4, 2021
W-2 Managing EmployeeChief Compliance Officer Oct 4, 2021
Marilyn Tucker Individual Corporate DirectorBoard Member Aug 16, 2012
Nicole L Moore Individual Corporate DirectorBoard Member Aug 12, 2014

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1420761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762732800000",
    "number": "1619366978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 FULTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112171517",
            "telephone_number": "718-596-9800",
            "fax_number": "718-596-9889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "297 MYRTLE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112052901",
            "telephone_number": "718-596-8000",
            "fax_number": "718-596-8935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITMAN INGERSOLL FARRAGUT HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BROOKLYN PLAZA MEDICAL CENTER, INC",
        "enumeration_date": "2015-01-09",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "SYLVIA",
        "authorized_official_title_or_position": "REVENUE MANGAER",
        "authorized_official_telephone_number": "718-596-9800"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NY",
            "license": "7001250R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619366978",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Whitman Ingersoll Farragut Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.