NPIMap

Organization Active NPI

The Child Center of Ny, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Woodside, NY
National Provider Identifier
1801945738
Registry record updated Dec 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
THE CHILD CENTER OF NY, INC.
Practice address
6714 41St Ave
Woodside, NY 11377-3790
Phone
(718) 458-4243
Fax
(718) 458-4481
NPI assigned
Jan 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2013

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

Authorized official

Name
Ms. Jean M Coppola
Title
Director of Billing
Phone
(718) 651-7770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary

Addresses

Primary practice location

6714 41St Ave
Woodside, NY 11377-3790

Mailing address

6002 Queens Blvd
Lower Level
Woodside, NY 11377-4973
Phone (718) 651-7770

Other identifiers 3

IdentifierTypeStateIssuer
7403085OtherNYGHI
WV0071OtherNYBLUE CROSS BLUE SHIELD
00244371MedicaidNY

Other names 1

  • Woodside Clinic Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041101000022 NY Part B Supplier - Clinic/Group Practice 8426010638 Receives reassigned benefits from 66 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Elmhurst, NY; Flushing, NY; Jamaica, NY; New York, NY; Woodside, NY

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Tax ID family
Child Center of New York36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

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

View all 35

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387411200000",
    "number": "1801945738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6002 QUEENS BLVD",
            "address_2": "LOWER LEVEL",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113774973",
            "telephone_number": "718-651-7770",
            "fax_number": "718-651-5029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6714 41ST AVE",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773790",
            "telephone_number": "718-458-4243",
            "fax_number": "718-458-4481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CHILD CENTER OF NY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2013-12-19",
        "status": "A",
        "authorized_official_last_name": "COPPOLA",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING",
        "authorized_official_telephone_number": "718-651-7770",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "7403085",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "WV0071",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00244371",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodside Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Woodside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2013; 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.