NPIMap

Organization Active NPI

Oda Primary Health Care Network, Inc.

  • Primary Care Clinic/Center
  • Brooklyn, NY
National Provider Identifier
1720177066
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
PFI0845 Issued in NY
Legal business name
ODA PRIMARY HEALTH CARE NETWORK, INC.
Practice address
14 Heyward St
Brooklyn, NY 11249-7823
Phone
(718) 260-4600
Fax
(718) 852-0867
NPI assigned
Oct 12, 2006
Last updated
Jan 4, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Authorized official

Name
Mr. Joseph Deutsch
Title
Ceo
Phone
(718) 260-4600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X PFI0845 NY Primary

Addresses

Primary practice location

14 Heyward St
Brooklyn, NY 11249-7823

Mailing address

14 Heyward St
Brooklyn, NY 11249-7823
Phone (718) 260-4600

Other identifiers 1

IdentifierTypeStateIssuer
00357548MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY5 enrollments

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
O20100301000219 NY Part A Provider - Federally Qualified Health Center (FQHC) 8729123815 Practice locations: Brooklyn, NY
O20110725000527 NY Part A Provider - Federally Qualified Health Center (FQHC) 8729123815 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Brooklyn, NY
O20131219000446 NY Part A Provider - Federally Qualified Health Center (FQHC) 8729123815 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Woodridge, NY
O20131219000643 NY Part A Provider - Federally Qualified Health Center (FQHC) 8729123815 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Brooklyn, NY
O20150819009123 NY Part A Provider - Federally Qualified Health Center (FQHC) 8729123815 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Monticello, NY

NPI to CCN mapping 5

The Medicare certification numbers (CCNs) connected to NPI 1720177066. Details of each certification follow.

Federally qualified health center certification: CCN 331834

Legal name
ODA PRIMARY HEALTH CARE NETWORK INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 23, 1974 in NY
Enrollment address
14 Heyward St
Brooklyn, NY 11249-7823

Federally qualified health center certification: CCN 331042

Legal name
ODA PRIMARY HEALTH CARE NETWORK INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 15, 2011
Last certification
Aug 15, 2011
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 23, 1974 in NY
Enrollment address
517 Park Ave
Brooklyn, NY 11205-1783
Related CCNs
331834

Federally qualified health center certification: CCN 331087

Legal name
ODA PRIMARY HEALTH CARE NETWORK INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 26, 2013
Last certification
Dec 26, 2013
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 23, 1974 in NY
Enrollment address
6 Dairyland Rd
Woodridge, NY 12789-5540
Related CCNs
331834

Federally qualified health center certification: CCN 331086

Legal name
ODA PRIMARY HEALTH CARE NETWORK INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 24, 2013
Last certification
Dec 24, 2013
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 29, 1974 in NY
Enrollment address
329 Hewes St
Brooklyn, NY 11211-7474
Related CCNs
331834

Federally qualified health center certification: CCN 331168

Legal name
ODA PRIMARY HEALTH CARE NETWORK INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 16, 2015
Last certification
Sep 16, 2015
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 29, 1974 in NY
Enrollment address
60 Jefferson St
Monticello, NY 12701-1122

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

Other NPIs with the same Medicare PAC ID 10

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

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory

Locations

14 Heyward St
Brooklyn, NY 11249
Phone 71826046001035

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Issac a Katz Individual Corporate Director Mar 1, 2003
Corporate DirectorBoard Member Mar 1, 2003
Louis Kestenbaum Individual Corporate Director Feb 1, 2008
Aron Engel Individual Corporate Director Jul 1, 2010
Corporate DirectorBoard Member May 5, 2015
Corporate DirectorBoard Member May 1, 2010
Akiva Kobre Individual Corporate DirectorBoard Member Nov 1, 2013
Chavie Lieberman Individual Corporate Director Jan 1, 1992
Corporate DirectorBoard Member May 5, 2015
Corporate DirectorBoard Member Jan 1, 1992
Rose Rosenfeld Individual Corporate OfficerChief Financial Officer Jun 3, 2015 0.33%
Operational/Managerial ControlCfo Jun 3, 2015 0.33%
Corporate OfficerChief Financial Officer Jun 3, 2015
Operational/Managerial Control Jun 3, 2015
Joseph Deutsch Individual Corporate OfficerCeo Jan 1, 2014 34%
Corporate OfficerCeo May 5, 2013
Corporate OfficerCeo Jan 7, 2013 33%
Corporate OfficerCeo Jan 7, 2013
Moshe Friedman Individual Corporate DirectorBoard Member Jun 1, 2016
Corporate DirectorBoard Member Dec 1, 2009
Naftali Ausch Individual Corporate DirectorSecretary Jan 1, 1988
Corporate DirectorBoard Member Dec 31, 1988
Naftali Horowitz Individual Corporate DirectorBoard Member Jan 1, 2001
Corporate DirectorBoard Member Mar 1, 2003
David Hurwitz Individual Corporate Director Mar 1, 2003
Abraham Friedlander Individual Corporate DirectorBoard Member Nov 1, 1991
Abraham Pearl Individual Corporate OfficerCfo Jan 1, 2023
W-2 Managing EmployeeCfo Jan 1, 2023
Corporate Director Jan 1, 2023
W-2 Managing Employee Jan 1, 2023
Jeffrey Chyau Individual W-2 Managing Employee Jan 1, 2019

Practitioners & affiliated clinicians

Practitioners 114

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 114

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641254400000",
    "number": "1720177066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 HEYWARD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112497823",
            "telephone_number": "718-260-4600",
            "fax_number": "718-852-0867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 HEYWARD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112497823",
            "telephone_number": "718-260-4600",
            "fax_number": "718-852-0867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODA PRIMARY HEALTH CARE NETWORK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A",
        "authorized_official_last_name": "DEUTSCH",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-260-4600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NY",
            "license": "PFI0845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00357548",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.