NPIMap

Organization Active NPI

Queens Village Committee for Mental Health for J-Cap, Inc

  • Multi-Specialty Clinic/Center
  • Jamaica, NY
National Provider Identifier
1679641757
Registry record updated Sep 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
QUEENS VILLAGE COMMITTEE FOR MENTAL HEALTH FOR J-CAP, INC
Practice address
116-30 Sutphin Blvd.
Jamaica, NY 11434-1527
Phone
(718) 322-2500
Fax
(718) 322-1881
NPI assigned
Nov 30, 2006
Last updated
Sep 23, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2022

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

Authorized official

Name
Vicky Gatell
Title
Chief Financial Officer
Phone
(718) 960-7629

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary
Substance Abuse Rehabilitation Facility 324500000X 090310090 NY

Addresses

Primary practice location

116-30 Sutphin Blvd.
Jamaica, NY 11434-1527

Mailing address

311 E 175TH St
Bronx, NY 10457-5859
Phone (718) 960-7568

Other identifiers 1

IdentifierTypeStateIssuer
01090000MedicaidNY

Other names 1

  • j-cap Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140806002052 NY Part B Supplier - Clinic/Group Practice 0749407237 Receives reassigned benefits from 3 practitioners
Practice locations: Jamaica, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2126463Queens Village Committee for Mental Health116-30 Sutphin Blvd, Jamaica, NY 11434Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

Locations

11630 Sutphin Blvd
Jamaica, NY 11434
Phone (718) 322-2500

Practitioners & affiliated clinicians

Practitioners 19

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 19

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663891200000",
    "number": "1679641757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 E 175TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104575859",
            "telephone_number": "718-960-7568",
            "fax_number": "718-481-8693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116-30 SUTPHIN BLVD.",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114341527",
            "telephone_number": "718-322-2500",
            "fax_number": "718-322-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEENS VILLAGE COMMITTEE FOR MENTAL HEALTH FOR J-CAP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A",
        "authorized_official_last_name": "GATELL",
        "authorized_official_first_name": "VICKY",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "718-960-7629"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NY",
            "license": "090310090",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01090000",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "j-cap",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "j-cap",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.