NPIMap

Organization Active NPI

The Child Center of Ny, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Forest Hills, NY
National Provider Identifier
1649329806
Registry record updated Jan 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
THE CHILD CENTER OF NY, INC.
Practice address
11835 Queens Blvd
6TH Floor
Forest Hills, NY 11375-7211
Phone
(718) 651-7770
Fax
(718) 396-8349
NPI assigned
Jan 9, 2007
Last updated
Jan 18, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2017

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

Authorized official

Name
Ms. Jean M Coppola
Title
Billing System Administrator
Phone
(718) 651-7770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU Primary

Addresses

Primary practice location

11835 Queens Blvd
6TH Floor
Forest Hills, NY 11375-7211

Mailing address

11835 Queens Blvd
6TH Floor
Forest Hills, NY 11375-7211
Phone (718) 651-7770

Other identifiers 3

IdentifierTypeStateIssuer
00244371MedicaidNY
WV0071OtherNYBLUE CROSS BLUE SHIELD
7403085OtherNYGHI

Other names 1

  • Queens Child Guidance Center, 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
O20041101000022 NY Part B Supplier - Clinic/Group Practice 8426010638 Receives reassigned benefits from 66 practitioners
7 other NPIs on this enrollment
Practice locations: Elmhurst, NY; Flushing, NY; Jamaica, NY; New York, NY; Woodside, NY

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Tax ID family
Child Center of New York36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

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

View all 35

Locations

16318 Jamaica Ave
Ste 2
Jamaica, NY 11432
Phone (718) 297-8000

8956 162nd St
#2
Jamaica, NY 11432
Phone (718) 657-7100

201A E 124th St
New York, NY 10035
Phone (212) 831-5020

Practitioners & affiliated clinicians

Practitioners 130

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 130

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484697600000",
    "number": "1649329806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11835 QUEENS BLVD",
            "address_2": "6TH FLOOR",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757211",
            "telephone_number": "718-651-7770",
            "fax_number": "718-396-8349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11835 QUEENS BLVD",
            "address_2": "6TH FLOOR",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757211",
            "telephone_number": "718-651-7770",
            "fax_number": "718-396-8349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CHILD CENTER OF NY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2017-01-18",
        "status": "A",
        "authorized_official_last_name": "COPPOLA",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BILLING SYSTEM ADMINISTRATOR",
        "authorized_official_telephone_number": "718-651-7770",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00244371",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "WV0071",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "7403085",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Queens Child Guidance Center, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2017; 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.