NPIMap

Organization Active NPI

Community Healthcare Network, Inc.

  • Federally Qualified Health Center (FQHC)
  • Long Island City, NY
National Provider Identifier
1952542771
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTHCARE NETWORK, INC.
Practice address
36-11 21St St
Long Island City, NY 11106
Phone
(718) 482-7772
Fax
(718) 482-4698
NPI assigned
Mar 9, 2009
Last updated
Sep 12, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Authorized official

Name
Alan J. Wengrofsky
Title
Cfo/Vice President of Finance
Phone
(212) 545-2481

Specialties & licenses 1

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

Addresses

Primary practice location

36-11 21St St
Long Island City, NY 11106

Mailing address

44 W 28TH Street
Floor 5
New York, NY 10001-4212
Phone (212) 545-2409

Other identifiers 1

IdentifierTypeStateIssuer
00695941MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

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
O20120214000365 NY Part A Provider - Federally Qualified Health Center (FQHC) 7416855143 Practice locations: Long Island City, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1952542771. Details of each certification follow.

Federally qualified health center certification: CCN 331009

Legal name
COMMUNITY HEALTHCARE NETWORK INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 16, 2009
Last certification
Nov 16, 2009
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 18, 1978 in NY
Enrollment address
36-11 21St Street
Long Island City, NY 11106-4505

Other NPIs with the same Medicare PAC ID 12

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

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

Locations

999 Blake Ave
Brooklyn, NY 11208
Phone (718) 277-8303

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Edwidge J Thomas Individual Corporate OfficerBoard Member Aug 19, 2021
Corporate DirectorBoard Member Aug 19, 2021
Caroline Dorsen Individual Corporate OfficerVice Chair Feb 18, 2016
Corporate DirectorVice Chair Feb 18, 2016
Robert M. Hayes Individual Corporate OfficerPresident and Ceo Jan 20, 2015
Corporate DirectorPresident and Ceo Jan 20, 2015
W-2 Managing EmployeePresident and Ceo Jan 20, 2015
Alan J Wengrofsky Individual Corporate OfficerVice President of Finance and Cfo Jul 25, 2008
Corporate DirectorVice President of Finance and Cfo Jul 25, 2008
W-2 Managing EmployeeVice President of Finance and Cfo Jul 25, 2008
Taisha L Benjamin Individual Corporate OfficerChief Medical Officer Aug 21, 2014
Denise Gordon Individual Corporate DirectorBoard Member Dec 1, 2016
Elizabeth Krob-Kellner Individual Corporate DirectorBoard Member Oct 1, 2007
Roger Platt Individual Corporate OfficerBoard Member Aug 19, 2021
Corporate DirectorBoard Member Aug 19, 2021
Richard Barasch Individual Corporate DirectorBoard Member Dec 1, 2023
June E Niklus Individual Corporate OfficerBoard Member Mar 1, 1995
Corporate DirectorBoard Member Mar 1, 1995
Kathleen O'Neill Individual Corporate DirectorBoard Member Dec 1, 2020
Randy P Siller Individual Corporate OfficerBoard Member May 1, 2014
Corporate DirectorBoard Member May 1, 2014
Rhonda Kotelchuck Individual Corporate OfficerBoard Member Nov 1, 2018
Corporate DirectorBoard Member Nov 1, 2018
Kristin L Manzolillo Individual Corporate OfficerSecretary Oct 15, 2015
Corporate DirectorSecretary Oct 15, 2015
Donna E Anderson Individual Corporate DirectorBoard Member Dec 1, 2023
Greta Elysee Individual Corporate Officer Jan 1, 1998
Corporate DirectorBoard Member Jan 1, 1998
Curtis Young Individual Corporate OfficerBoard Member Aug 19, 2021
Corporate DirectorBoard Member Aug 19, 2021
Josephine Diaz Individual Corporate OfficerBoard Member May 1, 2010
Corporate DirectorBoard Member May 1, 2010

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 3

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": "1236556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757635200000",
    "number": "1952542771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 W 28TH STREET",
            "address_2": "FLOOR 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100014212",
            "telephone_number": "212-545-2409",
            "fax_number": "646-312-0481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36-11 21ST ST",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "11106",
            "telephone_number": "718-482-7772",
            "fax_number": "718-482-4698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTHCARE NETWORK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-09",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A",
        "authorized_official_last_name": "WENGROFSKY",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CFO/VICE PRESIDENT OF FINANCE",
        "authorized_official_telephone_number": "212-545-2481"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00695941",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

Verify at the official NPI Registry.