NPIMap

Organization Active NPI

City of New York Office of Payroll Administration

Doing business as New York City Dept of Health & Mental Hygiene Fort Green District Heal

  • State or Local Public Health Clinic/Center
  • Brooklyn, NY
National Provider Identifier
1982624276
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X
Legal business name
CITY OF NEW YORK OFFICE OF PAYROLL ADMINISTRATION
Doing business as
New York City Dept of Health & Mental Hygiene Fort Green District Heal
Practice address
295 Flatbush Avenue Ext
Brooklyn, NY 11201-3001
Phone
(347) 396-7959
Fax
(718) 643-1520
NPI assigned
Jul 20, 2006
Last updated
Jan 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Authorized official

Name
Janet Ellis
Title
Director of Patient Billing
Phone
(347) 396-6299

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
State or Local Public Health Clinic/Center 261QP0905X NU Primary

Addresses

Primary practice location

295 Flatbush Avenue Ext
Brooklyn, NY 11201-3001

Mailing address

4209 28TH St # CN-48
Long Island City, NY 11101-4130
Phone (347) 396-6299

Other identifiers 1

IdentifierTypeStateIssuer
00247567MedicaidNY

Other names 1

  • New York City Dept of Health & Mental Hygiene Fort Green District Heal Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040406001483 NY Part B Supplier - Clinic/Group Practice 9739172644 Receives reassigned benefits from 69 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Staten Island, NY; New York, NY; Long Island City, NY; Jamaica, NY; Jackson Heights, NY; Brooklyn, NY; Bronx, NY

Other NPIs on the same Medicare enrollment 15

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

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Nycdohmh Bed Stuy Connect CMCM46 organizations share this tax ID, including this one

Other organizations with this tax ID 45

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

View all 45

Locations

1309 Fulton Ave
Bronx, NY 10456
Phone (718) 566-3587

295 Flatbush Avenue Ext
Brooklyn, NY 11201
Phone (212) 566-3587

295 Flatbush Avenue Ext
Fl 2
Brooklyn, NY 11201
Phone (347) 396-6299

4209 28th St
#15111
Long Island City, NY 11101
Phone (347) 396-4853

Practitioners & affiliated clinicians

Practitioners 51

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.

View all 51

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1982624276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4209 28TH ST # CN-48",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111014130",
            "telephone_number": "347-396-6299",
            "fax_number": "347-396-6367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 FLATBUSH AVENUE EXT",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112013001",
            "telephone_number": "347-396-7959",
            "fax_number": "718-643-1520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF NEW YORK OFFICE OF PAYROLL ADMINISTRATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "DIRECTOR OF PATIENT BILLING",
        "authorized_official_telephone_number": "347-396-6299"
    },
    "taxonomies": [
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00247567",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New York City Dept of Health & Mental Hygiene Fort Green District Heal",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "New York City Dept of Health & Mental Hygiene Fort Green District Heal",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.