Metro Community Health Centers, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Staten Island, NY
NPI 1649516352 · NPPES record last updated Mar 23, 2026
Key facts
- NPI
- 1649516352
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 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
- Organization subpart
- No
Authorized official
- Name
- Xayveon Williams
- Title
- Contract & Credentialing Manager
- Phone
- (718) 665-7565
Other NPIs on the same Medicare enrollment 3
Other NPIs with the same Medicare PAC ID 3
Corporate family (same tax ID) 4
Practitioners 20
-
Andrea M Nichols, MD
-
Leon Zacharowicz, MD
-
Damilola Motunrayo Babalola, FNP-BC, FNP-C
-
Thomas A Hays, MD
-
Ira Louis Salom, MD
-
Kimberly Reilly, APRN, FNP-BC
-
Ritamarie Bilello, DDS
-
Reham A Dabiesh, DDS
-
Chris Donikyan, DO
-
Elizabeth Lefoldt Strub, PMHNP-BC
-
Hari Om Agarwal, DDS
-
Robert A Miele, DPM
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NY
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
- Other · Non-profit
- Incorporated
- Nov 2, 2012 in NY
- Enrollment address
- 2324 Forest Ave
Staten Island, NY 10303-1506
All disclosed owners & managing parties 9
| Name | Role | Since | Share |
|---|---|---|---|
| James Johansen |
Corporate Director |
Aug 5, 2015 | |
| Lynn C Arola |
Corporate Director |
Aug 5, 2015 | |
| Jose Virella |
Corporate Officer |
Mar 1, 2018 | |
| W-2 Managing Employee |
Mar 1, 2018 | ||
| Mae Covington-Coggins |
Corporate Director |
Aug 5, 2015 | |
| Monique Dennis-Farrington |
Corporate Director |
Aug 5, 2015 | |
| Nellie Santiago-Rivera |
Corporate Officer | Nov 21, 2016 | |
| W-2 Managing Employee |
Nov 21, 2016 | ||
| Operational/Managerial Control |
Nov 21, 2016 | ||
| Jacqueline Tripodi |
Corporate Director |
Aug 8, 2018 | |
| Terrence Savage |
Corporate Officer |
Aug 5, 2015 | |
| Linda Tempel |
Corporate Director |
Aug 5, 2015 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- Metro Community Health Centers Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | |||
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04238597 | Medicaid | NY |
NPI Registry JSON
{
"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": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 23, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.