NPIMap

Organization Active NPI

Community Health Project Inc.

  • Federally Qualified Health Center (FQHC)
  • Brooklyn, NY
National Provider Identifier
1700516135
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH PROJECT INC.
Practice address
1561 Bedford Ave Ste Groundb
Brooklyn, NY 11225-1306
Phone
(212) 271-7200
NPI assigned
Jun 17, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Authorized official

Name
Marc Murphy
Title
Manager of Compliance and Risk
Phone
(212) 271-7191

Specialties & licenses 1

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

Addresses

Primary practice location

1561 Bedford Ave Ste Groundb
Brooklyn, NY 11225-1306

Mailing address

356 W 18TH St
New York, NY 10011-4401
Phone (212) 271-7200

Other names 1

  • Callen-Lorde Satellite at Brooklyn Community Pride Center Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040325001467 NY Part B Supplier - Clinic/Group Practice 1254223217 Receives reassigned benefits from 99 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
O20240102002441 NY Part A Provider - Federally Qualified Health Center (FQHC) 1254223217 Practice locations: Brooklyn, NY

Federally qualified health center certification: CCN 571846

Legal name
COMMUNITY HEALTH PROJECT, INC.
Doing business as
CALLEN-LORDE COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 1, 2023
Last certification
Dec 1, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 14, 1985 in NY
Enrollment address
1561 Bedford Ave
Ste Groundb
Brooklyn, NY 11225-1306

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory
Tax ID family
Community Health Project11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

1561 Bedford Ave
Brooklyn, NY 11225
Phone (347) 978-8753

208 W 13th St
New York, NY 10011
Phone (212) 620-7310

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
William Craig Individual Corporate DirectorBoard Member Jun 1, 2019
James Evans Individual Corporate DirectorBoard Member May 1, 2016
Bethany Jankunis Individual Corporate DirectorBoard Secretary Nov 1, 2019
Carl Gaines Individual Corporate DirectorBoard Member Jun 1, 2019
Patrick McGovern Individual Corporate OfficerChief Executive Officer Aug 1, 2023
Corporate DirectorChief Executive Officer Aug 1, 2023
W-2 Managing EmployeeChief Executive Officer Aug 1, 2023
Blane Charles Individual Corporate DirectorBoard Member Nov 1, 2019
Geremy Kawaller Individual Corporate DirectorBoard Treasurer Jun 1, 2019
Shane Stephen Spicer Individual Corporate DirectorBoard Member Apr 1, 2015
Lisa Mazzola Individual Corporate DirectorCompliance Officer Sep 6, 2016
W-2 Managing EmployeeDirector of Compliance Sep 6, 2016
Daniel McGee Individual Corporate DirectorBoard Member Jun 1, 2017
Matthew Cohen Individual Corporate DirectorBoard Vice Chair Oct 1, 2015
James Asci Individual Corporate DirectorBoard Member Jun 1, 2021
Lanita Ward Jones Individual Corporate DirectorBoard Chair Oct 1, 2015
Giselle Byrd Individual Corporate DirectorBoard Member Jun 1, 2021
William G Pagano Individual Corporate DirectorBoard Member Jun 1, 2017

Practitioners & affiliated clinicians

Practitioners 87

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

View all 87

NPI Registry JSON

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

{
    "created_epoch": "1655424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697068800000",
    "number": "1700516135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "356 W 18TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100114401",
            "telephone_number": "212-271-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1561 BEDFORD AVE STE GROUNDB",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112251306",
            "telephone_number": "212-271-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH PROJECT INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-17",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A",
        "authorized_official_last_name": "MURPHY",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "MANAGER OF COMPLIANCE AND RISK",
        "authorized_official_telephone_number": "212-271-7191"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Callen-Lorde Satellite at Brooklyn Community Pride Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Callen-Lorde Satellite at Brooklyn Community Pride Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.