Middletown Community Health Center, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

MIDDLETOWN COMMUNITY HEALTH CENTER, INC.

Practice address

10 Brotherhood Plaza Dr
Washingtonville, NY 10992-2260

Phone

(845) 614-5981

NPI assigned

Dec 19, 2013

Last updated

May 22, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Maryjo Jobity

Title

Cfo

Phone

(845) 343-7614

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1942621800. Details of each certification follow.

• CCN 331109 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 331109

Legal name

MIDDLETOWN COMM HEALTH CENTER

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

May 14, 2014

Last certification

May 14, 2014

Ownership / control type

For profit – corporation

Facility address

10 Brotherhood Plaza Drive
Washingtonville, NY 10992

Related CCNs

331897

Locations

Practitioners 1

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.

• Joan Romero-McLoughlin, MSN, ANP-BC

  • Adult Health Nurse Practitioner
  • Washingtonville, NY
  • NPI 1326444761
  NPD (past)

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

{
    "created_epoch": "1387411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400716800000",
    "number": "1942621800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 ORCHARD ST",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109405004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 BROTHERHOOD PLAZA DR",
            "city": "WASHINGTONVILLE",
            "state": "NY",
            "postal_code": "109922260",
            "telephone_number": "845-614-5981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLETOWN COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-19",
        "last_updated": "2014-05-22",
        "status": "A",
        "authorized_official_last_name": "JOBITY",
        "authorized_official_first_name": "MARYJO",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "845-343-7614"
    },
    "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": "00355931",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joan Michele Maulella, LICENSED MASSAGE
• Jennifer McClernon, ATC
• Joseph McGann, DO
• Medical Supply Solutions, Inc.
• Ariannie Medina
• Barbara A Milmore, FNP
• Erin Elizabeth Milteer, LMSW
• Monell Engine Comany
• Montefiore Medical Center
• Deasia Moore

• Federally Qualified Health Center (FQHC) in Washingtonville, NY
• Providers in Washingtonville, NY by specialty
• Federally Qualified Health Center (FQHC) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.