NPIMap

Organization Active NPI

Apicha Community Health Center

  • Federally Qualified Health Center (FQHC)
  • New York, NY
National Provider Identifier
1730303017
Registry record updated Nov 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
APICHA COMMUNITY HEALTH CENTER
Practice address
400 Broadway
New York, NY 10013-3698
Phone
(212) 334-6029
Fax
(212) 334-7957
NPI assigned
Apr 11, 2007
Last updated
Nov 3, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2020

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

Authorized official

Name
Teresita R Rodriguez
Title
Chief Executive Officer
Phone
(212) 334-7940

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Health Service Clinic/Center 261QH0100X

Addresses

Primary practice location

400 Broadway
New York, NY 10013-3698

Mailing address

400 Broadway
New York, NY 10013-3698
Phone (212) 334-6029

Other identifiers 1

IdentifierTypeStateIssuer
02997175MedicaidNY

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090430000540 NY Part B Supplier - Clinic/Group Practice 0840348843 Receives reassigned benefits from 23 practitioners
1 other NPI on this enrollment
Practice locations: New York, NY; Jackson Heights, NY
O20130905000399 NY Part A Provider - Federally Qualified Health Center (FQHC) 0840348843 Practice locations: New York, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1730303017. Details of each certification follow.

Federally qualified health center certification: CCN 331080

Legal name
APICHA COMMUNITY HEALTH CENTER
Doing business as
ASIAN AND PACIFIC ISLANDER COALITION ON HIV/AIDS, INC. (APICHA, INC.)
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 10, 2013
Last certification
Oct 10, 2013
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
400 Broadway
New York, NY 10013-3698

Other NPIs with the same Medicare PAC ID 2

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
Apicha Community Health Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

8211 37th Ave
Fl 45
Jackson Heights, NY 11372

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Paulette Sherlock Individual W-2 Managing EmployeeDirector Revenue Cycle & Pat Accts Oct 2, 2017
Li Hung Lin Individual Corporate OfficerVice Chair Jul 12, 2017
Lydia Anne Isaac Individual Corporate DirectorBoard Member Mar 1, 2020
Gertrudes Pajaron Individual Corporate OfficerChief Development Officer Jul 15, 2003
Anthony Feliciano Individual Corporate DirectorBoard Member May 4, 2014
Nathaly Rubio-Torio Individual Corporate DirectorBoard Member Mar 1, 2020
National Health Consulting Organization, Syosset, NY Consulting firm Operational/Managerial Control Jan 5, 2016
Andrew Rogers Individual Corporate OfficerTreasurer Mar 1, 2019
Charles King Individual Corporate DirectorBoard Member Jul 11, 2017
Mihaela Mihai Individual W-2 Managing EmployeeChief Operation Officer Oct 1, 2012
Ira Rothblut Individual Contracted Managing EmployeeCfo Mar 1, 2017
Teresita R Rodriguez Individual Corporate OfficerCeo Sep 10, 2009
James Luisi Individual Corporate DirectorBoard Member Jun 1, 2022
Yumiko Sano Individual Corporate OfficerCoo Sep 10, 2009
Louis Madigan Individual Corporate OfficerVice Chair and Treasurer Nov 14, 2012
Mario Lopez de Leon Individual Corporate DirectorBoard Member Aug 1, 2022
Edgardo Nieves Individual Contracted Managing EmployeeCio Feb 1, 2018
Ruoh Pyng Aka Flora Ferng Individual Corporate OfficerSecretary May 1, 2018
Corporate DirectorBoard Member May 8, 2018
James Young Individual Corporate DirectorBoard Member Oct 1, 2022
Raymund Vincent Sebastian Sison Individual Corporate OfficerDirector of Medicine Jul 15, 2019

Owners & managing parties with NPI records 1

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

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 24

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 24

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604361600000",
    "number": "1730303017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100133698",
            "telephone_number": "212-334-6029",
            "fax_number": "212-334-7957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100133698",
            "telephone_number": "212-334-6029",
            "fax_number": "212-334-7957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APICHA COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "TERESITA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "212-334-7940"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02997175",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.