NPIMap

Organization Active NPI

Metro Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Staten Island, NY
National Provider Identifier
1649516352
Registry record updated Mar 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
METRO COMMUNITY HEALTH CENTERS, INC.
Practice address
2324 Forest Ave
Staten Island, NY 10303-1506
Phone
(718) 447-0200
NPI assigned
Dec 27, 2012
Last updated
Mar 23, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2026

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

Authorized official

Name
Xayveon Williams
Title
Contract & Credentialing Manager
Phone
(718) 665-7565

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

2324 Forest Ave
Staten Island, NY 10303-1506

Mailing address

979 Cross Bronx Expy
Bronx, NY 10460-4885
Phone (718) 665-7565

Other identifiers 1

IdentifierTypeStateIssuer
04238597MedicaidNY

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140912000473 NY Part B Supplier - Clinic/Group Practice 8921227687 Receives reassigned benefits from 58 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bronx, NY; Brooklyn, NY; New York, NY; Staten Island, NY
O20160223001106 NY Part A Provider - Federally Qualified Health Center (FQHC) 8921227687 Practice locations: Staten Island, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1649516352. Details of each certification follow.

Federally qualified health center certification: CCN 331190

Legal name
METRO COMMUNITY HEALTH CENTERS INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 1, 2016
Last certification
Mar 1, 2016
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Nov 2, 2012 in NY
Enrollment address
2324 Forest Ave
Staten Island, NY 10303-1506

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
Metro Community Health Centers Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Ownership & related parties

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
James Johansen Individual Corporate DirectorBoard of Director Aug 5, 2015
Lynn C Arola Individual Corporate DirectorBoard of Director Aug 5, 2015
Jose Virella Individual Corporate OfficerChief Executive Officer Mar 1, 2018
W-2 Managing EmployeeChief Executive Officer Mar 1, 2018
Mae Covington-Coggins Individual Corporate DirectorBoard of Director Aug 5, 2015
Monique Dennis-Farrington Individual Corporate DirectorBoard of Director Aug 5, 2015
Nellie Santiago-Rivera Individual Corporate Officer Nov 21, 2016
W-2 Managing EmployeeChief Operating Officer Nov 21, 2016
Operational/Managerial ControlChief Operating Officer Nov 21, 2016
Jacqueline Tripodi Individual Corporate DirectorBoard of Director Aug 8, 2018
Terrence Savage Individual Corporate OfficerChief Information Officer Aug 5, 2015
Linda Tempel Individual Corporate DirectorBoard of Director Aug 5, 2015

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1356566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774224000000",
    "number": "1649516352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "979 CROSS BRONX EXPY",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104604885",
            "telephone_number": "718-665-7565",
            "fax_number": "718-750-3448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2324 FOREST AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103031506",
            "telephone_number": "718-447-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METRO COMMUNITY HEALTH CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-27",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "XAYVEON",
        "authorized_official_title_or_position": "CONTRACT & CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "718-665-7565"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04238597",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.