NPIMap

Organization Active NPI

Housing Works Health Services III, Inc.

  • Federally Qualified Health Center (FQHC)
  • Brooklyn, NY
National Provider Identifier
1750934436
Registry record updated Sep 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HOUSING WORKS HEALTH SERVICES III, INC.
Practice address
2640 Pitkin Ave
Oasas Department
Brooklyn, NY 11208-2629
Phone
(718) 827-8700
NPI assigned
Jul 22, 2019
Last updated
Sep 30, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
HOUSING WORKS HEALTH SERVICES III, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 30, 2026

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

Authorized official

Name
Debora Carrero
Title
Director of Credentialling
Phone
(718) 408-6522

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU

Addresses

Primary practice location

2640 Pitkin Ave
Oasas Department
Brooklyn, NY 11208-2629

Mailing address

57 Willoughby St
Brooklyn, NY 11201-5257

Other identifiers 2

IdentifierTypeStateIssuer
01826104MedicaidNY
05784809MedicaidNY

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110930000487 NY Part B Supplier - Clinic/Group Practice 7113199852 Receives reassigned benefits from 37 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Brooklyn, NY; New York, NY
O20230508002201 NY Part A Provider - Federally Qualified Health Center (FQHC) 7113199852 Practice locations: Brooklyn, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1750934436. Details of each certification follow.

Federally qualified health center certification: CCN 331821

Legal name
HOUSING WORKS HEALTH SERVICES III INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 8, 2023
Last certification
Jun 8, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
in NY
Enrollment address
2640 Pitkin Ave
Brooklyn, NY 11208-2763

Other NPIs with the same Medicare PAC ID 1

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
Part of
Housing Works Health Services III Inc

Locations

145 E 125th St
New York, NY 10035
Phone (646) 595-7440

301 W 37th St
Fl 4
New York, NY 10018
Phone (212) 216-9500

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Jolanta Ilczuk Individual Corporate Director Aug 12, 2011
W-2 Managing Employee Aug 12, 2011
Matthew Bernardo Individual Corporate Director Aug 12, 2011
Chenelle Nixon Individual Corporate Director Jul 1, 2013
Frank Quintero Individual Corporate Director Sep 1, 2014
Charles King Individual Corporate OfficerCheif Executive Officer Apr 27, 2004 100%
Corporate Director Jul 2, 2007
Kathy Gueye Individual Corporate Director Sep 1, 2011
Debora Carrero Individual Corporate Director Jan 1, 2016
W-2 Managing Employee Jan 1, 2016
Marion Conde Individual Corporate Director Jul 1, 2013

Practitioners & affiliated clinicians

Practitioners 27

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 27

NPI Registry JSON

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

{
    "created_epoch": "1563753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790726400000",
    "number": "1750934436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 WILLOUGHBY ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 PITKIN AVE",
            "address_2": "OASAS DEPARTMENT",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112082629",
            "telephone_number": "718-827-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOUSING WORKS HEALTH SERVICES III, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOUSING WORKS HEALTH SERVICES III, INC.",
        "enumeration_date": "2019-07-22",
        "last_updated": "2026-09-30",
        "certification_date": "2026-09-30",
        "status": "A",
        "authorized_official_last_name": "CARRERO",
        "authorized_official_first_name": "DEBORA",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALLING",
        "authorized_official_telephone_number": "718-408-6522"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01826104",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05784809",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.