Organization Active NPI

Community Health Project Inc.

  • Federally Qualified Health Center (FQHC)
  • New York, NY
National Provider Identifier
1972913473
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH PROJECT INC.
Practice address
356 W 18TH St
6TH Floor
New York, NY 10011-4401
Phone
(212) 271-7200
Fax
(212) 271-7225
NPI assigned
May 6, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2026

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

Authorized official

Name
Victor De la Cruz
Title
Payer Enrollment Analyst
Phone
(212) 271-7228

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

356 W 18TH St
6TH Floor
New York, NY 10011-4401

Mailing address

356 W 18TH St
New York, NY 10011-4462
Phone (212) 271-7200

Other identifiers 1

IdentifierTypeStateIssuer
04101204MedicaidNY

Other names 1

  • Callen-Lorde Integrated Health Center Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040325001467 NY Part B Supplier - Clinic/Group Practice 1254223217 Receives reassigned benefits from 99 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
O20141120001773 NY Part A Provider - Federally Qualified Health Center (FQHC) 1254223217 Practice locations: New York, NY

Federally qualified health center certification: CCN 331131

Legal name
COMMUNITY HEALTH PROJECT, INC.
Doing business as
CALLEN-LORDE COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 12, 2014
Last certification
Dec 12, 2014
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 14, 1985 in NY
Enrollment address
356 W 18TH St
FL 6
New York, NY 10011-4401

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory
Tax ID family
Community Health Project11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

356 W 18th St
Fl 6
New York, NY 10011
Phone (212) 271-7167

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
William Craig Individual Corporate DirectorBoard Secretary May 11, 2016
James Evans Individual Corporate DirectorBoard Secretary May 11, 2016
Paul Shay Individual Corporate DirectorBoard Member Mar 19, 2025
Bethany Jankunis Individual Corporate DirectorBoard Member Nov 13, 2019
Vickie Tillman Individual Corporate DirectorTreasurer Sep 21, 2022
Carl Gaines Individual Corporate DirectorBoard Vice Chair Sep 12, 2018
Patrick McGovern Individual Corporate DirectorChief Executive Officer Aug 1, 2023
W-2 Managing EmployeeChief Executive Officer Aug 1, 2023
Matthew McMorrow Individual Corporate DirectorBoard Member Mar 19, 2025
Blane Charles Individual Corporate DirectorBoard Member Nov 13, 2019
Shane Stephen Spicer Individual Corporate DirectorBoard Member Apr 29, 2015
Daniel McGee Individual Corporate DirectorBoard Member Jun 21, 2017
June Stafford Individual Corporate DirectorBoard Member Jun 27, 2018
Matthew Cohen Individual Corporate DirectorBoard Chair Oct 28, 2015
Lanita Ward Jones Individual Corporate DirectorBoard Member Oct 28, 2015
Giselle Byrd Individual Corporate DirectorBoard Member Jun 16, 2021
Bella Batista Individual Corporate DirectorBoard Member Sep 21, 2022
William G Pagano Individual Corporate DirectorBoard Member Jun 21, 2017
Faiz Osman Individual Corporate DirectorBoard Member Mar 20, 2024

Practitioners & affiliated clinicians

Practitioners 83

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

View all 83

NPI Registry JSON

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

{
    "created_epoch": "1399334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768435200000",
    "number": "1972913473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "356 W 18TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100114462",
            "telephone_number": "212-271-7200",
            "fax_number": "212-271-7225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "356 W 18TH ST",
            "address_2": "6TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100114401",
            "telephone_number": "212-271-7200",
            "fax_number": "212-271-7225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH PROJECT INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-06",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A",
        "authorized_official_last_name": "DE LA CRUZ",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "PAYER ENROLLMENT ANALYST",
        "authorized_official_telephone_number": "212-271-7228"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04101204",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Callen-Lorde Integrated Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.