Middletown Community Health Center Inc

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

Legal business name

MIDDLETOWN COMMUNITY HEALTH CENTER INC

Doing business as

United Community Health Center

Practice address

99 Cameron Street
Pine Bush, NY 12566

Phone

(845) 744-2067

Fax

(845) 343-5390

NPI assigned

Feb 7, 2007

Last updated

Mar 25, 2011By the provider in NPPES

Organization subpart

Yes

Parent organization

MIDDLETOWN COMMUNITY HEALTH CENTER INCAs reported in NPPES

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

Authorized official

Name

Ms. Theresa Maloney

Title

Ceo

Phone

(845) 343-7614

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• United Community Health Center Doing business as

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 1972643492. Details of each certification follow.

• CCN 331900 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 331900

Legal name

MIDDLETOWN COMMUNITY HEALTH CENTER

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Aug 20, 2001

Last certification

Aug 20, 2001

Ownership / control type

For profit – partnership

Facility address

99 Cameron Street
Pine Bush, NY 12566

Part of

Donald B Niebel

Locations

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301011200000",
    "number": "1972643492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 987",
            "address_2": "21 ORCHARD STREET",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109400987",
            "telephone_number": "845-343-7614",
            "fax_number": "845-343-5390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 CAMERON STREET",
            "city": "PINE BUSH",
            "state": "NY",
            "postal_code": "12566",
            "telephone_number": "845-744-2067",
            "fax_number": "845-343-5390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLETOWN COMMUNITY HEALTH CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MIDDLETOWN COMMUNITY HEALTH CENTER INC",
        "enumeration_date": "2007-02-07",
        "last_updated": "2011-03-25",
        "status": "A",
        "authorized_official_last_name": "MALONEY",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "845-343-7614",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00355931",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "United Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelli Ann Meland-Lewis, PHD
• Erica Mercurio
• Sarah Meredith, FNP
• Joanne Faye Mermell, RN
• Mary Helen Micinowski, C.O.T.A.
• Susan Miller Rannestad, CM, LM
• Montefiore Medical Center
• Beth Morales, RCS
• Nicole Mule, LPN
• Kerry A Murphy, OTR

• Community Health Clinic/Center in Pine Bush, NY
• Providers in Pine Bush, NY by specialty
• Community Health Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2011; 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.