NPIMap

Organization Active NPI

Broward Community and Family Health Centers Inc

  • Federally Qualified Health Center (FQHC)
  • West Park, FL
National Provider Identifier
1902040454
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
BROWARD COMMUNITY AND FAMILY HEALTH CENTERS INC
Practice address
5800 W Hallandale Beach Blvd
West Park, FL 33023-5244
Phone
(954) 966-3939
Fax
(954) 966-5959
NPI assigned
Apr 28, 2009
Last updated
Aug 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Authorized official

Name
Rosalyn Frazier
Title
Ceo
Phone
(954) 967-0028

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

5800 W Hallandale Beach Blvd
West Park, FL 33023-5244

Mailing address

5010 Hollywood Blvd
100B
Hollywood, FL 33021-6557
Phone (954) 967-0028

Other identifiers 3

IdentifierTypeStateIssuer
680027104MedicaidFL
680027105MedicaidFL
680027111MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041020000942 FL Part B Supplier - Clinic/Group Practice 9032170345 Receives reassigned benefits from 26 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: West Park, FL; Pompano Beach, FL; Lauderhill, FL; Hollywood, FL
O20100107000735 FL Part A Provider - Federally Qualified Health Center (FQHC) 9032170345 Practice locations: West Park, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902040454. Details of each certification follow.

Federally qualified health center certification: CCN 101037

Legal name
BROWARD COMMUNITY AND FAMILY HEALTH CENTERS INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 7, 2010
Last certification
Jan 7, 2010
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 14, 1998 in FL
Enrollment address
5800 W Hallandale Beach Blvd
West Park, FL 33023-5244

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Tax ID family
Broward Community and Family Health Centers Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

5010 Hollywood Blvd
Hollywood, FL 33021

1295 NW 40th Ave
#200
Lauderhill, FL 33313
Phone (954) 583-4710

1201 NW 6th Ave
Bldg 21
Pompano Beach, FL 33060
Phone (954) 266-2999

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • HealthSun Health Plans Network
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Lonnise Baldwin Individual Corporate DirectorBoard Member Jul 1, 2009
Felicia Brunson Individual Corporate DirectorBoard Member May 1, 2007
Arthur Rogers Individual Corporate DirectorBoard Member Jul 1, 2009
Alvin Kelly Individual Corporate DirectorBoard of Directors Jan 1, 2017
Monique Tavares Individual Corporate DirectorBoard of Directors Jan 1, 2017
Joseph Browne Individual Corporate DirectorBoard of Directors Mar 31, 2014
Suze Ernest Individual Corporate DirectorBoard of Directors Jan 1, 2017
Rosalyn Frazier Individual Corporate DirectorPresident/Ceo Jul 1, 2009 100%
W-2 Managing EmployeePresident/Ceo Jul 1, 2009 100%
Fernando Miranda Individual Corporate DirectorBoard Member Jul 1, 2009

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1240876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722816000000",
    "number": "1902040454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5010 HOLLYWOOD BLVD",
            "address_2": "100B",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216557",
            "telephone_number": "954-967-0028",
            "fax_number": "954-272-0294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 W HALLANDALE BEACH BLVD",
            "city": "WEST PARK",
            "state": "FL",
            "postal_code": "330235244",
            "telephone_number": "954-966-3939",
            "fax_number": "954-966-5959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROWARD COMMUNITY AND FAMILY HEALTH CENTERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-28",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A",
        "authorized_official_last_name": "FRAZIER",
        "authorized_official_first_name": "ROSALYN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "954-967-0028"
    },
    "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": "680027104",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "680027105",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "680027111",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Park, FL

Sources for this page

Verify at the official NPI Registry.