NPIMap

Organization Active NPI

Urban Health Plan, Inc.

  • Federally Qualified Health Center (FQHC)
  • Bronx, NY
National Provider Identifier
1982758066
Registry record updated Mar 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
URBAN HEALTH PLAN, INC.
Doing business as
Bella Vista Health Center
Practice address
890 Hunts Point Ave
Bronx, NY 10474-5402
Phone
(718) 589-2440
Fax
(718) 589-4793
NPI assigned
Jan 23, 2007
Organization subpart
Yes
Parent organization
BELLA VISTA HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 17, 2011

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

Authorized official

Name
Ms. Alexandra Borbon
Title
Director, Managed Care Office, Cont
Phone
(718) 589-2440

Specialties & licenses 1

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

Addresses

Primary practice location

890 Hunts Point Ave
Bronx, NY 10474-5402

Mailing address

1065 Southern Boulevard
Bronx, NY 10452-2417
Phone (718) 589-2440

Other identifiers 2

IdentifierTypeStateIssuer
00244977MedicaidNY
02994952-00244977MedicaidNY

Other names 1

  • Bella Vista 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
O20040412001518 NY Part B Supplier - Clinic/Group Practice 3173517281 Receives reassigned benefits from 273 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bronx, NY; Corona, NY; Elmhurst, NY; New York, NY
O20100304000094 NY Part A Provider - Federally Qualified Health Center (FQHC) 3173517281 Practice locations: Bronx, NY

Federally qualified health center certification: CCN 331938

Legal name
URBAN HEALTH PLAN INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 8, 2004
Last certification
Jun 8, 2004
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 21, 1973 in NY
Enrollment address
890 Hunts Point Ave
Bronx, NY 10474-5402
Related CCNs
331885

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 24

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

View all 24

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
Urban Health Plan Inc27 organizations share this tax ID, including this one
Part of
Urban Health Plan Inc

Other organizations with this tax ID 26

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

View all 26

Locations

890 Hunts Point Ave
Bronx, NY 10474
Phone (718) 589-2141

1065 Southern Blvd
Bronx, NY 10459
Phone 71858924404222

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Paloma Hernandez Individual Corporate OfficerPresident and Ceo Jun 21, 1974
Corporate DirectorPresidentand Ceo Jun 21, 1974
W-2 Managing EmployeePresident and Ceo Jun 21, 1974
Operational/Managerial ControlPresident and Ceo Jun 21, 1974
Janette Stanford Individual Corporate DirectorBoard Member Jan 1, 2023
Rhynna Santos Individual Corporate DirectorBoard Member Sep 26, 2019
Joan Rivera-Baker Individual Corporate DirectorBoard Member/Secretary Jan 1, 2008
Linda Baldwin Individual Corporate DirectorBoard Member Mar 23, 2003
Charles Gonzalez Individual Corporate DirectorBoard Member Jun 15, 1998
Edward S Butts Individual Corporate DirectorBoard Member Jul 28, 2011
Clifford Charles Individual Corporate DirectorBoard Member/Treasurer Mar 23, 2009
Oswaldo a Guzman Individual Corporate DirectorBoard Member Jan 1, 2013
Howard Hinestroza Individual Corporate DirectorBoard Member Oct 27, 2016
Yoselin Genao Individual Corporate DirectorBoard Member Nov 15, 2016
Robert C Alvis Individual Corporate DirectorBoard Member Jan 1, 2023

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300320000000",
    "number": "1982758066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 SOUTHERN BOULEVARD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104522417",
            "telephone_number": "718-589-2440",
            "fax_number": "718-991-4516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 HUNTS POINT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104745402",
            "telephone_number": "718-589-2440",
            "fax_number": "718-589-4793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "URBAN HEALTH PLAN, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BELLA VISTA HEALTH CENTER",
        "enumeration_date": "2007-01-23",
        "last_updated": "2011-03-17",
        "status": "A",
        "authorized_official_last_name": "BORBON",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_title_or_position": "DIRECTOR, MANAGED CARE OFFICE, CONT",
        "authorized_official_telephone_number": "718-589-2440",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00244977",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02994952-00244977",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bella Vista Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.