NPIMap

Organization Active NPI

Lasante Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Brooklyn, NY
National Provider Identifier
1740672732
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LASANTE HEALTH CENTER INC
Practice address
672 Parkside Ave
2ND Floor
Brooklyn, NY 11226-1506
Phone
(718) 246-5700
Fax
(718) 246-5750
NPI assigned
Feb 27, 2015
Last updated
Oct 19, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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

Authorized official

Name
Gedalya Blumenfrucht
Title
Cfo
Phone
(718) 246-5700

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Health Service Clinic/Center 261QH0100X

Addresses

Primary practice location

672 Parkside Ave
2ND Floor
Brooklyn, NY 11226-1506

Mailing address

672 Parkside Ave
2ND Floor
Brooklyn, NY 11226-1506
Phone (718) 246-5700

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20161220001437 NY Part B Supplier - Clinic/Group Practice 6204117872 Receives reassigned benefits from 16 practitioners
Practice locations: Brooklyn, NY
O20180212002033 NY Part A Provider - Federally Qualified Health Center (FQHC) 6204117872 Practice locations: Brooklyn, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740672732. Details of each certification follow.

Federally qualified health center certification: CCN 571096

Legal name
LASANTE HEALTH CENTER INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 16, 2018
Last certification
Apr 16, 2018
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 20, 2013 in NY
Enrollment address
672 Parkside Ave
Brooklyn, NY 11226-1506

National Provider Directory

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
Yves Vilus Individual Corporate DirectorBoard Member / Board Secretary Jun 1, 2016
Gedalya Blumenfrucht Individual Corporate OfficerCfo Jul 17, 2017
W-2 Managing EmployeeCfo Jul 17, 2017
Bryndle Selmar Individual Corporate DirectorBoard Member Jun 1, 2016
Ilia Nieves-Hoque Individual Corporate DirectorBoard Member Mar 29, 2023
Solomon Reiner Individual Corporate DirectorBoard Member Jun 1, 2016
Wendy Powell Individual Corporate DirectorBoard Member Sep 27, 2017
Rhoda Jacobs Individual Corporate DirectorBoard Member Dec 17, 2015
Lilian Otero Individual Corporate DirectorBoard Member Nov 27, 2017
Marie Desruisseau Individual Corporate DirectorBoard Member Mar 20, 2013
Shabsey Oberlander Individual Corporate DirectorBoard Member/ Chairman of Board Jun 1, 2016
Mendel Rottenberg Individual Corporate DirectorBoard Member/ Treasurer Mar 20, 2013

Subparts reporting this organization as parent 6

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

Practitioners & affiliated clinicians

Practitioners 39

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 39

NPI Registry JSON

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

{
    "created_epoch": "1424995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603065600000",
    "number": "1740672732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "672 PARKSIDE AVE",
            "address_2": "2ND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112261506",
            "telephone_number": "718-246-5700",
            "fax_number": "718-246-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "672 PARKSIDE AVE",
            "address_2": "2ND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112261506",
            "telephone_number": "718-246-5700",
            "fax_number": "718-246-5750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LASANTE HEALTH CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-27",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A",
        "authorized_official_last_name": "BLUMENFRUCHT",
        "authorized_official_first_name": "GEDALYA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "718-246-5700"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.