NPIMap

Organization Active NPI

Cornerstone Family Healthcare

  • Federally Qualified Health Center (FQHC)
  • Newburgh, NY
National Provider Identifier
1689669079
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CORNERSTONE FAMILY HEALTHCARE
Practice address
147 Lake Street
Newburgh, NY 12550-5242
Phone
(845) 563-8000
Fax
(845) 563-8093
NPI assigned
Sep 13, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Authorized official

Name
David Jolly
Title
Ceo
Phone
(845) 220-3165

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Hearing Aid Equipment 332S00000X 000425 NY

Addresses

Primary practice location

147 Lake Street
Newburgh, NY 12550-5242

Mailing address

2570 Route 9W
Suite 10
Cornwall, NY 12518-1323
Phone (845) 220-3100

Other identifiers 3

IdentifierTypeStateIssuer
WCW271OtherNYMEDICARE ID
331832OtherNYMEDICARE ID
00472931MedicaidNY

Other names 1

  • The Greater Hudson Valley Family Health Center, Inc. Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, WI13 enrollments
Opioid treatment program
Medicare-enrolled since Jan 1, 2020

Enrollment records 13

Enrollment IDStateProvider typePAC IDDetails
O20051024000183 NY Part B Supplier - Clinic/Group Practice 4880610393 Receives reassigned benefits from 90 practitioners
Practice locations: Wallkill, NY; Binghamton, NY; Port Jervis, NY; Pine Bush, NY; Newburgh, NY; New Windsor, NY; Middletown, NY; New City, NY…
O20100412000079 WI Part A Provider - Federally Qualified Health Center (FQHC) 4880610393 Practice locations: Newburgh, NY
O20110913000066 NY Part A Provider - Federally Qualified Health Center (FQHC) 4880610393 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Newburgh, NY
O20111028000043 NY Part A Provider - Federally Qualified Health Center (FQHC) 4880610393 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: New Windsor, NY
O20131114001183 NY Part A Provider - Federally Qualified Health Center (FQHC) 4880610393 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Highland Falls, NY
O20160405001723 NY Part A Provider - Federally Qualified Health Center (FQHC) 4880610393 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Binghamton, NY
O20171102001433 NY Part A Provider - Federally Qualified Health Center (FQHC) 4880610393 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: New City, NY
O20180227001025 NY Part A Provider - Federally Qualified Health Center (FQHC) 4880610393 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Middletown, NY
O20180227001477 NY Part A Provider - Federally Qualified Health Center (FQHC) 4880610393 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pine Bush, NY
O20180313000071 NY Part A Provider - Federally Qualified Health Center (FQHC) 4880610393 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Middletown, NY
O20180316000857 NY Part A Provider - Federally Qualified Health Center (FQHC) 4880610393 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Port Jervis, NY
O20180627002675 NY Part A Provider - Federally Qualified Health Center (FQHC) 4880610393 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wallkill, NY
O20200312000270 NY Part B Supplier - Opioid Treatment Program (Otp) 4880610393 Practice locations: Newburgh, NY

Federally qualified health center certification: CCN 331832

Legal name
CORNERSTONE FAMILY HEALTHCARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 1, 1992
Last certification
Jan 1, 1992
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Feb 6, 1981 in NY
Enrollment address
147 Lake St
Newburgh, NY 12550-5263

Federally qualified health center certification: CCN 331032

Legal name
CORNERSTONE FAMILY HEALTHCARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 26, 2011
Last certification
Oct 26, 2011
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 6, 1981 in NY
Enrollment address
100 Broadway
Newburgh, NY 12550-5514
Related CCNs
331832

Federally qualified health center certification: CCN 331031

Legal name
CORNERSTONE FAMILY HEALTHCARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 28, 2011
Last certification
Oct 28, 2011
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 6, 1981 in NY
Enrollment address
91 Blooming Grove Tpke
New Windsor, NY 12553-7757
Related CCNs
331832

Federally qualified health center certification: CCN 331094

Legal name
CORNERSTONE FAMILY HEALTHCARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 14, 2013
Last certification
Nov 14, 2013
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 6, 1981 in NY
Enrollment address
127 Main St
Highland Falls, NY 10928-4019

Federally qualified health center certification: CCN 331199

Legal name
CORNERSTONE FAMILY HEALTHCARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 5, 2016
Last certification
May 5, 2016
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 6, 1981 in NY
Enrollment address
35 Felters Rd
Binghamton, NY 13903-2600

Federally qualified health center certification: CCN 571085

Legal name
CORNERSTONE FAMILY HEALTHCARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 28, 2017
Last certification
Nov 28, 2017
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 6, 1981 in NY
Enrollment address
260 N Little Tor Rd
New City, NY 10956-2627

Federally qualified health center certification: CCN 571091

Legal name
CORNERSTONE FAMILY HEALTHCARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 6, 2018
Last certification
Mar 6, 2018
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 6, 1981 in NY
Enrollment address
10 Benton Ave
Middletown, NY 10940-5177

Federally qualified health center certification: CCN 571100

Legal name
CORNERSTONE FAMILY HEALTHCARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 28, 2018
Last certification
Mar 28, 2018
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 6, 1981 in NY
Enrollment address
99 Cameron St
Pine Bush, NY 12566-7113

Federally qualified health center certification: CCN 571122

Legal name
CORNERSTONE FAMILY HEALTHCARE
Doing business as
CORNERSTONE FAMILY HEALTHCARE: MIDDLETOWN PEDIATRICS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 14, 2018
Last certification
Aug 14, 2018
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 6, 1981 in NY
Enrollment address
14 Grove St
Middletown, NY 10940-4806

Federally qualified health center certification: CCN 571093

Legal name
CORNERSTONE FAMILY HEALTHCARE
Doing business as
CORNERSTONE FAMILY HEALTHCARE AT PORT JERVIS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 20, 2018
Last certification
Mar 20, 2018
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 6, 1981 in NY
Enrollment address
140 Hammond St
Port Jervis, NY 12771-2607

Federally qualified health center certification: CCN 571123

Legal name
CORNERSTONE FAMILY HEALTHCARE
Doing business as
CORNERSTONE FAMILY HEALTHCARE AT PLATTEKILL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 14, 2018
Last certification
Aug 14, 2018
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 6, 1981 in NY
Enrollment address
24 Old Fire House Rd
Wallkill, NY 12589-4600

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 11

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

Other NPIs on the same Medicare enrollment 10

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

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
33D2100071Cornerstone Family Healthcare147 Lake Street, Newburgh, NY 12550Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

Locations

127 Main St
Highland Fls, NY 10928
Phone (845) 446-4040

160 E Main St
Port Jervis, NY 12771
Phone (845) 856-7000

Ownership & related parties

All disclosed owners & managing parties 26

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

NameRoleSinceShare
Gopal Bhalla Individual Corporate DirectorBoard Member Aug 22, 2023
Corporate OfficerBoard Member Aug 22, 2023
Michele McKeon Individual Corporate DirectorBoard Member Apr 26, 2022
Corporate OfficerBoard Member Apr 26, 2022
Nelson McAllister Individual Corporate DirectorBoard Member Jan 1, 2002
Corporate OfficerBoard Member Jan 1, 2002
Andrew Bell Individual Corporate DirectorBoard Member Apr 27, 2021
Corporate OfficerBoard Member Apr 27, 2021
Debra Johnson Individual Corporate DirectorBoard Member Jan 1, 2008
Corporate OfficerBoard Member Jan 1, 2008
Jason T Giordano Individual Corporate DirectorBoard Member Jul 26, 2022
Corporate OfficerBoard Member Jul 26, 2022
Rhonda Green Individual Corporate DirectorBoard Member Apr 1, 2019
Corporate OfficerBoard Member May 1, 2013
Corporate OfficerBoard Member Apr 1, 2019
Daisy Vale Individual Corporate DirectorBoard Member Apr 1, 2007
Corporate OfficerBoard Member Apr 1, 2007
Corporate DirectorBoard Member Apr 1, 2017
Cheryl Ross Individual Corporate DirectorBoard Member Nov 1, 2018
Corporate OfficerBoard Member Nov 1, 2018
David Jolly Individual Corporate OfficerCeo/President Jan 6, 2023
W-2 Managing EmployeeCeo/President Jan 6, 2023
Corporate DirectorCeo/President Jan 6, 2023
Elizabeth L Miller Individual Corporate DirectorBoard Member Apr 23, 2024
Corporate OfficerBoard Member Apr 23, 2024
Aretha Thompson Individual Corporate DirectorBoard Member Apr 27, 2021
Corporate OfficerBoard Member Apr 27, 2021
Daniel Lamb Individual Corporate DirectorBoard Member Apr 25, 2017
Corporate OfficerBoard Member Apr 25, 2017
Corporate DirectorBoard Member Apr 24, 2017
Dareshanie D'Arpino Individual Corporate DirectorBoard Member Apr 23, 2024
Corporate OfficerBoard Member Apr 23, 2024
Amy Ansehl Individual Corporate DirectorBoard Member Apr 27, 2021
Corporate OfficerBoard Member Apr 27, 2021
Randall Volney Coffill Individual Corporate DirectorBoard Member Jun 27, 2023
Corporate OfficerBoard Member Jun 27, 2023
Paul Ernenwein Individual Corporate DirectorBoard Member Jan 1, 2014
Corporate OfficerBoard Member Jan 1, 2014
Inaudy Esposito Individual Corporate DirectorBoard Member Jan 25, 2022
Corporate OfficerBoard Member Jan 25, 2022
Leonora C Gerspach-Siegel Individual Corporate OfficerBoard Member Apr 22, 2025
Patricia Claiborne Individual Corporate OfficerBoard Member Jul 1, 2018
Corporate DirectorBoard Member Jul 1, 2018
Wayne Day Individual Corporate OfficerBoard Member Jan 1, 2008
Corporate DirectorBoard Member Jan 1, 2008
Andrew Sherman Evans Individual Corporate OfficerBoard Member Apr 27, 2021
Corporate DirectorBoard Member Apr 27, 2021
Charles a Walwyn Individual Corporate OfficerBoard Member Apr 25, 2017
Corporate DirectorBoard Member Apr 25, 2017
Marlene Medina Individual Corporate OfficerBoard Member Mar 1, 2015
Corporate DirectorBoard Member Mar 1, 2015
Eric Gatsik Individual Corporate OfficerBoard Member Jan 1, 2015
Corporate DirectorBoard Member Jan 1, 2015
Randall V Coffill Individual Corporate DirectorBoard Member Jun 27, 2023

Subparts reporting this organization as parent 11

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 105

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

View all 105

NPI Registry JSON

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674086400000",
    "number": "1689669079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2570 ROUTE 9W",
            "address_2": "SUITE 10",
            "city": "CORNWALL",
            "state": "NY",
            "postal_code": "125181323",
            "telephone_number": "845-220-3100",
            "fax_number": "845-534-2940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 LAKE STREET",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125505242",
            "telephone_number": "845-563-8000",
            "fax_number": "845-563-8093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE FAMILY HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-13",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A",
        "authorized_official_last_name": "JOLLY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "845-220-3165"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332S00000X",
            "taxonomy_group": "",
            "desc": "Hearing Aid Equipment",
            "state": "NY",
            "license": "000425",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "WCW271",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "331832",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00472931",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Greater Hudson Valley Family Health Center, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "The Greater Hudson Valley Family Health Center, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Newburgh, NY

Sources for this page

Verify at the official NPI Registry.