NPIMap

Organization Active NPI

William F Ryan Community Health Center Inc

Doing business as Thelma C Davidson Adair William F. Ryan Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • New York, NY
National Provider Identifier
1730317769
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
WILLIAM F RYAN COMMUNITY HEALTH CENTER INC
Doing business as
Thelma C Davidson Adair William F. Ryan Community Health Center Inc
Practice address
565 Manhattan Ave
New York, NY 10027-5250
Phone
(212) 222-5221
NPI assigned
Jun 29, 2009
Last updated
Jul 15, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
WILLIAM F RYAN COMMUNITY HEALTH CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Authorized official

Name
Mr. Jose Virella
Title
Chief Financial Officer
Phone
(212) 316-7906

Specialties & licenses 1

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

Addresses

Primary practice location

565 Manhattan Ave
New York, NY 10027-5250

Mailing address

565 Manhattan Ave
New York, NY 10027-5250
Phone (212) 222-5221

Other identifiers 1

IdentifierTypeStateIssuer
03178452MedicaidNY

Other names 1

  • THELMA C DAVIDSON ADAIR WILLIAM F. RYAN COMMUNITY HEALTH CENTER INC Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041023000026 NY Part B Supplier - Clinic/Group Practice 4880596550 Receives reassigned benefits from 203 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: New York, NY
O20090727000491 NY Part A Provider - Federally Qualified Health Center (FQHC) 4880596550 Practice locations: New York, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1730317769. Details of each certification follow.

Federally qualified health center certification: CCN 331006

Legal name
WILLIAM F RYAN COMMUNITY HEALTH CENTER INC
Doing business as
THELMA C DAVIDSON ADAIR WILLIAM F RYAN COMMUNITY HEATH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 15, 2009
Last certification
Sep 15, 2009
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 22, 1978 in NY
Enrollment address
565 Manhattan Ave
New York, NY 10027-5250

Other NPIs with the same Medicare PAC ID 7

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
Amy H Korobow MD12 organizations share this tax ID, including this one
Part of
Amy H Korobow MD

Other organizations with this tax ID 11

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

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Valeria Spann Individual Corporate DirectorBoard Member Jan 6, 2004
Harriet King Individual Corporate DirectorVice Chair Jan 1, 1989
Philip Chen Individual Corporate DirectorBoard Member Jul 31, 2015
Scott D Morgan Individual Corporate OfficerChief Financial Officer May 21, 2018
Margaret Gramins Individual Corporate DirectorBoard Member Jun 5, 2017
Hope Mason Individual Corporate DirectorBoard Member Jan 1, 1987
Juli a Harkins Individual Corporate DirectorBoard Member Jul 1, 2016
Ronald Guy Individual Corporate DirectorBoard Chair Feb 2, 2000
Joseph Haslip Individual Corporate DirectorBoard Member Jan 1, 2013
Ronnie Lowenstein Individual Corporate DirectorBoard Member Nov 6, 2017
Charles Shorter Individual Corporate DirectorExecutive Director Jul 1, 2009
W-2 Managing EmployeeExecutive Director Jul 1, 2009

Practitioners & affiliated clinicians

Practitioners 22

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 22

NPI Registry JSON

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

{
    "created_epoch": "1246233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721001600000",
    "number": "1730317769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "565 MANHATTAN AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100275250",
            "telephone_number": "212-222-5221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 MANHATTAN AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100275250",
            "telephone_number": "212-222-5221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM F RYAN COMMUNITY HEALTH CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WILLIAM F RYAN COMMUNITY HEALTH CENTER INC",
        "enumeration_date": "2009-06-29",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A",
        "authorized_official_last_name": "VIRELLA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "212-316-7906",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03178452",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THELMA C DAVIDSON ADAIR WILLIAM F. RYAN COMMUNITY HEALTH CENTER INC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "THELMA C DAVIDSON ADAIR WILLIAM F. RYAN COMMUNITY HEALTH CENTER INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.