NPIMap

Organization Active NPI

Community Healthcare Network, Inc

  • Non-emergency Medical Transport (VAN)
  • Jamaica, NY
National Provider Identifier
1801938709
Registry record updated Sep 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
License
ACG6747 Issued in NY
Legal business name
COMMUNITY HEALTHCARE NETWORK, INC
Practice address
9704 Sutphin Blvd
Jamaica, NY 11435-4721
Phone
(718) 657-7088
Fax
(718) 657-7092
NPI assigned
Feb 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2010

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

Authorized official

Name
Mrs. Michelle Djibo
Title
Director of Managed Care
Phone
(212) 545-2439

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X ACG6747 NY Primary

Addresses

Primary practice location

9704 Sutphin Blvd
Jamaica, NY 11435-4721

Mailing address

60 Madison Ave
Floor 5
New York, NY 10010-1600
Phone (212) 545-2439

Other identifiers 1

IdentifierTypeStateIssuer
00695941MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040322000987 NY Part B Supplier - Clinic/Group Practice 7416855143 Receives reassigned benefits from 108 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: New York, NY; Long Island City, NY; Jamaica, NY; Brooklyn, NY; Bronx, NY

Other NPIs on the same Medicare enrollment 16

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

View all 16

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283299200000",
    "number": "1801938709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 MADISON AVE",
            "address_2": "FLOOR 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100101600",
            "telephone_number": "212-545-2439",
            "fax_number": "646-312-0481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9704 SUTPHIN BLVD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114354721",
            "telephone_number": "718-657-7088",
            "fax_number": "718-657-7092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTHCARE NETWORK, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2010-09-01",
        "status": "A",
        "authorized_official_last_name": "DJIBO",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "DIRECTOR OF MANAGED CARE",
        "authorized_official_telephone_number": "212-545-2439",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NY",
            "license": "ACG6747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00695941",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.