NPIMap

Organization Active NPI

Finger Lakes Community Health

  • Federally Qualified Health Center (FQHC)
  • Penn Yan, NY
National Provider Identifier
1649519273
Registry record updated Feb 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
FINGER LAKES COMMUNITY HEALTH
Practice address
112 Kimball Ave
Penn Yan, NY 14527-1816
Phone
(315) 531-9102
Fax
(315) 531-9103
NPI assigned
Feb 1, 2013
Last updated
Feb 5, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
FINGER LAKES COMMUNITY HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 5, 2026

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

Authorized official

Name
Mary Ann Zelazney
Title
Ceo
Phone
(315) 531-9102

Specialties & licenses 1

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

Addresses

Primary practice location

112 Kimball Ave
Penn Yan, NY 14527-1816

Mailing address

14 Maiden LN
PO Box 423
Penn Yan, NY 14527-1208
Phone (315) 531-9102

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051215000087 NY Part B Supplier - Clinic/Group Practice 0244251486 Receives reassigned benefits from 49 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Port Byron, NY; Sodus, NY; Penn Yan, NY; Ovid, NY; Newark, NY; Geneva, NY; Dundee, NY; Bath, NY
O20130708000216 NY Part A Provider - Federally Qualified Health Center (FQHC) 0244251486 Practice locations: Penn Yan, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1649519273. Details of each certification follow.

Federally qualified health center certification: CCN 331066

Legal name
FINGER LAKES COMMUNITY HEALTH
Doing business as
FINGER LAKES COMMUNITY HEALTH MOBILE/DENTAL UNIT
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 8, 2013
Last certification
Jul 8, 2013
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 26, 2000 in NY
Enrollment address
112 Kimball Ave
Penn Yan, NY 14527-1816

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 8

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

National Provider Directory

National Provider Directory
Part of
Finger Lakes Community Health

Locations

112 Kimball Ave
Penn Yan, NY 14527
Phone (315) 531-9102

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
Martin Davis Individual Corporate Officer Oct 18, 2018
Mary Jo Dudley Individual Corporate OfficerBoard Member Jan 1, 2013 100%
Mary a Zelazny Individual Corporate DirectorCeo Aug 31, 2006
W-2 Managing EmployeeCeo Aug 31, 2006 100%
Michele L Dahl Individual W-2 Managing Employee Jan 1, 2012 100%
Rosario Jaramillo Individual Corporate OfficerBoard Member Jul 1, 2023
Nolberto Jaramillo Individual Corporate OfficerBoard Member Feb 1, 2018
Jamie Wetherall Individual Corporate DirectorCfo Jan 1, 2025
W-2 Managing EmployeeAd; Jan 1, 2024
Operational/Managerial ControlCfo Jan 1, 2024
Lawreen Duel Individual W-2 Managing EmployeeDirector of Operations Nov 1, 2011 100%
Susan K Loughnane Individual Corporate OfficerBoard Vice Chairperson May 1, 2010 100%
Janet Jaramillo Individual Corporate OfficerBoard Member Nov 1, 2023
Linda D Fox Individual Corporate OfficerBoard Member Jul 1, 2008 100%
Brett Fontaine Individual Corporate OfficerVice Chair of Board of Directors Apr 23, 2020

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1359676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770249600000",
    "number": "1649519273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 MAIDEN LN",
            "address_2": "PO BOX 423",
            "city": "PENN YAN",
            "state": "NY",
            "postal_code": "145271208",
            "telephone_number": "315-531-9102",
            "fax_number": "315-531-9103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 KIMBALL AVE",
            "city": "PENN YAN",
            "state": "NY",
            "postal_code": "145271816",
            "telephone_number": "315-531-9102",
            "fax_number": "315-531-9103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FINGER LAKES COMMUNITY HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FINGER LAKES COMMUNITY HEALTH",
        "enumeration_date": "2013-02-01",
        "last_updated": "2026-02-05",
        "certification_date": "2026-02-05",
        "status": "A",
        "authorized_official_last_name": "ZELAZNEY",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "315-531-9102"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Penn Yan, NY

Sources for this page

Verify at the official NPI Registry.