NPIMap

Organization Active NPI

Morris Heights Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Bronx, NY
National Provider Identifier
1669912341
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
7000236R Issued in NY
Legal business name
MORRIS HEIGHTS HEALTH CENTER, INC.
Practice address
1227 Edward L Grant Hwy
Bronx Medical and Wellness Center
Bronx, NY 10452-3101
Phone
(718) 716-4400
NPI assigned
Mar 1, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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

Authorized official

Name
Lourdes Clemente
Title
Sr. Manager, Revenue Cycle
Phone
(718) 716-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 7000236R NY Primary

Addresses

Primary practice location

1227 Edward L Grant Hwy
Bronx Medical and Wellness Center
Bronx, NY 10452-3101

Mailing address

85 W Burnside Ave
Bronx, NY 10453-4015
Phone (718) 924-2686

Other identifiers 1

IdentifierTypeStateIssuer
04890319MedicaidNY

Other names 1

  • Bronx Medical and Wellness Center Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110505000508 NY Part B Supplier - Clinic/Group Practice 3072798172 Receives reassigned benefits from 103 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Brooklyn, NY; Bronx, NY
O20170608000578 NY Part A Provider - Federally Qualified Health Center (FQHC) 3072798172 Practice locations: Bronx, NY

Federally qualified health center certification: CCN 571078

Legal name
MORRIS HEIGHTS HEALTH CENTER, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 15, 2017
Last certification
Jun 15, 2017
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 17, 1984 in NY
Enrollment address
1227 Edward Grant Highway
Bronx, NY 10452

Other NPIs with the same Medicare PAC ID 5

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
Morris Heights Health Center Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

85 W Burnside Ave
Bronx, NY 10453
Phone (718) 483-1270

1227 Edward L Grant Hwy
Bronx, NY 10452
Phone (929) 292-7500

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Alida E Quinones-Reyes Individual Operational/Managerial ControlSenior Vice President Oct 1, 1980
Debbian Fletcher-Blake Individual Operational/Managerial ControlChief Operational Officer Nov 19, 2015
Pamela W Smith Individual Operational/Managerial ControlVice President of Human Resources Aug 31, 2009
Claudette Phipps Individual Operational/Managerial ControlVice President Apr 7, 2008
Michelle Edden Individual Corporate DirectorBoard Secretary Oct 27, 2011
Marcia V Keizs Individual Corporate Director1St Vice Chair Mar 28, 2002
Gideon Dunkley Individual Corporate DirectorBoard Member May 24, 2007
Jose Serrano Individual Corporate DirectorBoard Member Oct 27, 1988
Lois Jeannine Bookhardt Murray Individual Operational/Managerial ControlInterim Chief Executive Officer Sep 22, 2016
Patrick Sterling Individual Corporate Director2ND Vice Chair Jan 22, 2004
Robert Mercedes Individual Corporate DirectorBoard Member Sep 27, 2012
Virginia Pou Individual Corporate DirectorBoard Member Dec 10, 2015
Prospere Remy Individual Corporate DirectorBoard Member Mar 25, 2004
Lois Stoddard Individual Operational/Managerial ControlChief Financial Officer Jun 17, 2016
Anne Elizabeth Fontaine Individual Operational/Managerial ControlCounsel and Compliance Officer Mar 16, 2016
Sandra Denis Individual Operational/Managerial ControlChief Behavioral Officer Sep 22, 2016
Paulette R Bainbridge Individual Corporate DirectorBoard Chairperson Feb 28, 2005

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1488326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734048000000",
    "number": "1669912341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 W BURNSIDE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534015",
            "telephone_number": "718-924-2686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 EDWARD L GRANT HWY",
            "address_2": "BRONX MEDICAL AND WELLNESS CENTER",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104523101",
            "telephone_number": "718-716-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORRIS HEIGHTS HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-01",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A",
        "authorized_official_last_name": "CLEMENTE",
        "authorized_official_first_name": "LOURDES",
        "authorized_official_title_or_position": "SR. MANAGER, REVENUE CYCLE",
        "authorized_official_telephone_number": "718-716-4000"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NY",
            "license": "7000236R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04890319",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bronx Medical and Wellness Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Bronx Medical and Wellness Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.