Metro Community Health Centers, Inc.

Organization Active NPI Federally Qualified Health Center (FQHC) · Brooklyn, NY

NPI 1972059467 · NPPES record last updated Mar 23, 2026

Key facts

NPI
1972059467
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
METRO COMMUNITY HEALTH CENTERS, INC.
Practice address
177 Livingston St Lowr Level
Brooklyn, NY 11201-7000
Phone
(718) 855-7707
NPI assigned
Aug 25, 2016
Organization subpart
No

Authorized official

Name
Xayveon Williams
Title
Contract & Credentialing Manager
Phone
(718) 665-7565

Other NPIs on the same Medicare enrollment 3

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

Other NPIs with the same Medicare PAC ID 3

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

Corporate family (same tax ID) 4

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

Practitioners 20

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in NY

Federally qualified health center certification: CCN 571047

Legal name
METRO COMMUNITY HEALTH CENTERS INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 31, 2016
Last certification
Oct 31, 2016
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Nov 2, 2012 in NY
Enrollment address
177 Livingston St
Lowr Level
Brooklyn, NY 11201-7000

All disclosed owners & managing parties 8

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

NameRoleSinceShare
James Johansen
Individual
Corporate Director
Board of Director
Aug 5, 2015
Lynn C Arola
Individual
Corporate Director
Board of Director
Aug 5, 2015
Jose Virella
Individual
Corporate Officer
Chief Executive Officer
Mar 1, 2018
W-2 Managing Employee
Chief Executive Officer
Mar 1, 2018
Mae Covington-Coggins
Individual
Corporate Director
Board of Director
Aug 5, 2015
Monique Dennis-Farrington
Individual
Corporate Director
Board of Director
Aug 5, 2015
Nellie Santiago-Rivera
Individual
Corporate Officer
Chief Executive Officer
Nov 21, 2016
W-2 Managing Employee
Chief Operating Officer
Nov 21, 2016
Operational/Managerial Control
Chief Operating Officer
Nov 21, 2016
Jacqueline Tripodi
Individual
Corporate Director
Board of Director
Aug 8, 2018
Linda Tempel
Individual
Corporate Director
Board of Director
Aug 5, 2015

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20140912000473 NY Part B Supplier - Clinic/Group Practice 8921227687 Receives reassigned benefits from 58 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bronx, NY; Brooklyn, NY; New York, NY; Staten Island, NY
O20161027001849 NY Part a Provider - Federally Qualified Health Center (FQHC) 8921227687 Practice locations: Brooklyn, NY

National Provider Directory

Tax ID family
Metro Community Health Centers Inc (5 organizations share this tax ID)

Locations

979 Cross Bronx Expy
Apt 11B
Bronx, NY 10460

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Developmental Disabilities Clinic/Center 261QD1600X
Federally Qualified Health Center (FQHC) 261QF0400X Yes

Addresses

Primary practice location

177 Livingston St Lowr Level
Brooklyn, NY 11201-7000

Mailing address

979 Cross Bronx Expy Apt 11B
Bronx, NY 10460-4885
Phone (718) 665-7565

Other identifiers

IdentifierTypeStateIssuer
04495552MedicaidNY

Other providers in Brooklyn, NY

All providers in Brooklyn, NY · Federally Qualified Health Center (FQHC) in New York

Sources for this page

Verify at the official NPI Registry.