NPIMap

Organization Active NPI

William F Ryan Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • New York, NY
National Provider Identifier
1851328199
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
Practice address
110 W 97TH St
New York, NY 10025
Phone
(212) 749-1820
Fax
(212) 280-4793
NPI assigned
Jun 26, 2006
Organization subpart
No

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 Primary

Addresses

Primary practice location

110 W 97TH St
New York, NY 10025

Mailing address

110 W 97TH St
New York, NY 10025
Phone (212) 749-1820

Other identifiers 1

IdentifierTypeStateIssuer
02999264MedicaidNY

Other names 1

  • William F Ryan CHC Inc Other name

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
Practice locations: New York, NY
O20080708000643 NY Part A Provider - Federally Qualified Health Center (FQHC) 4880596550 Practice locations: New York, NY

Federally qualified health center certification: CCN 331826

Legal name
WILLIAM F RYAN COMMUNITY HEALTH CENTER INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 1, 1991
Last certification
Nov 1, 1991
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Oct 22, 1978 in NY
Enrollment address
110 W 97TH St
New York, NY 10025-6450

Facilities connected through Provider of Services related, parent or unit certification numbers.

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

Locations

279 E 3rd St
New York, NY 10009
Phone (212) 477-8500

Ownership & related parties

All disclosed owners & managing parties 14

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 Director Jun 2, 2008
Harriet King Individual Corporate Director Jun 2, 2008
Anyanate G Jack Individual Corporate DirectorBoard Member Jul 1, 2019
Philip Chen Individual Corporate DirectorBoard Member Jul 31, 2015
Scott D Morgan Individual W-2 Managing EmployeeChief Financial Officer May 21, 2018
Margaret Gramins Individual Corporate DirectorBoard Member Jun 5, 2017
Lois Dorman Individual Corporate DirectorBoard Member Jul 1, 2019
Brian McIndoe Individual Corporate OfficerPresident & Ceo Jan 1, 2015
Hope Mason Individual Corporate Director Jun 2, 2008
Atif Abdul Haqq Individual Corporate DirectorBoard Member Oct 9, 2013
Juli a Harkins Individual Corporate DirectorBoard Member Jul 1, 2016
Ronald Guy Individual Corporate Director Jun 2, 2008
Joseph Haslip Individual Corporate DirectorBoard Member Jan 1, 2013
Ronnie Lowenstein Individual Corporate DirectorBoard Member Nov 6, 2017

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 209

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

View all 209

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721001600000",
    "number": "1851328199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W 97TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10025",
            "telephone_number": "212-749-1820",
            "fax_number": "212-280-4793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W 97TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10025",
            "telephone_number": "212-749-1820",
            "fax_number": "212-280-4793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM F RYAN COMMUNITY HEALTH CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-26",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02999264",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "William F Ryan CHC Inc",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "William F Ryan CHC Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.