BRONXCARE DR. MARTIN LUTHER KING JR. HEALTH CENTER (NPI# 1376898908) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376898908 |
| Entity Type | Organization |
| Organization Name | BRONXCARE DR. MARTIN LUTHER KING JR. HEALTH CENTER |
| Other Organization Name | BRONX CARE DR. MARTIN LUTHER KING JR. HEALTH CENTER |
| Practice Address |
321 E Tremont Ave Bronx NY 10457 |
| Mailing Address |
1276 Fulton Ave Bronx NY 10456-3402 |
| Practice Telephone | 7189018600 |
| Practice Fax Number | 7182931475 |
| Mailing Telephone | 7189018600 |
| Mailing Fax Number | 7182931475 |
| Enumeration Date | 2012-07-19 |
| Last Update Date | 2018-05-31 |
| Authorized Official Name | MR. VICTOR G DEMARCO (SENIOR VP-CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 7189018600 |
| Authorized Official Credential | CPA |
| Is Organization Subpart | Y |
| Parent Organization Name | DR MARTIN LUTHER KING JR HEALTH CENTER INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
7000212R | NY | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00244573 | 05 | |
| NY | BLUE CROSS | W0437 | 01 |
| Other Name | Type Code |
|---|---|
| Bronx Care Dr. Martin Luther King Jr. Health Center | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043518467 | Bronxcare Dr. Martin Luther King Jr. Health Center | Clinic/Center | 1591 Fulton Avenue, Bronx, NY 10457 | 2011-03-09 |
| 1073811485 | Bronxcare Dr. Martin Luther King Jr. Health Center | Clinic/Center | 1690 Bryant Avenue, Bronx, NY 10460 | 2011-03-09 |
| 1528366937 | Bronxcare Dr. Martin Luther King Jr. Health Center | Clinic/Center | 853 Tiffany Street, Bronx, NY 10459 | 2011-03-09 |
| 1588962906 | Bronxcare Dr. Martin Luther King Jr. Health Center | Clinic/Center | 2737-2741 3rd Avenue, Bronx, NY 10451 | 2011-03-09 |
| 1740558568 | Bronxcare Dr. Martin Luther King Jr. Health Center | Clinic/Center | 1067 Ogden Ave, Bronx, NY 10452 | 2011-12-07 |
| 1619275039 | Bronxcare Dr. Martin Luther King Jr. Health Center | Clinic/Center | 1775 Grand Concourse, Bronx, NY 10453 | 2011-03-09 |
| 1700184116 | Bronxcare Dr. Martin Luther King Jr. Health Center | Clinic/Center | 2432 Grand Concourse, Bronx, NY 10458 | 2011-03-09 |
| 1437231693 | Bronxcare Dr. Martin Luther King Jr. Health Center | Clinic/Center | 1265 Franklin Ave, Bronx, NY 10456 | 2006-10-19 |
| Street Address |
321 E TREMONT AVE |
| City | BRONX |
| State | NY |
| Zip Code | 10457 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376638247 | Ofelia T. Villar | Psychiatry & Neurology | 321 E Tremont Ave, Bronx, NY 10457-5304 | 2006-10-04 |
| 1023259769 | Janice E. Clemons | Substance Abuse Rehabilitation Facility | 321 E Tremont Ave, Bronx Lebanon Hospital, Bronx, NY 10457 | 2009-03-10 |
| 1386883585 | Soo-il Lee | Counselor | 321 E Tremont Ave, Bronx, NY 10457-5304 | 2009-02-11 |
| 1962640664 | Yvonne V Davis | Social Worker | 321 E Tremont Ave, Bronx, NY 10457-5304 | 2009-02-03 |
| 1699913350 | Mark Anthony Boyd Sr. | Counselor | 321 E Tremont Ave, Bronx, NY 10457-5304 | 2009-02-03 |
| 1518105303 | Shirley Riley-griffin | Counselor | 321 E Tremont Ave, Bronx, NY 10457-5304 | 2009-02-02 |
| 1083852933 | Martin Luther King Addictive Disease Services | Rehabilitation Hospital | 321 E Tremont Ave, Bronx, NY 10457-5304 | 2009-01-30 |
| 1366629891 | Kamala Alexandria Greene | Psychologist | 321 E Tremont Ave, Bronx, NY 10457-5304 | 2008-01-28 |
| 1578776969 | Pedro Ramos Pajela | Internal Medicine | 321 E Tremont Ave, Bronx, NY 10457-5304 | 2007-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346851722 | Aruna Muthumanickam | Student in an Organized Health Care Education/Training Program | 1650 Grand Concourse, The Bronx, New York City, NY 10457 | 2020-08-11 |
| 1013527753 | Cherine Awad | Student in an Organized Health Care Education/Training Program | 1650 Selwyn Avenue, Bronxcare Health System, Bronx, NY 10457 | 2020-08-07 |
| 1023626926 | Tolulope Oyinlola Olorunsogo | Student in an Organized Health Care Education/Training Program | 1650 Selwyn Avenue - Bronxcare Health System, Departmen, Suite 6h, Bronx, NY 10457 | 2020-07-16 |
| 1750999801 | Kalyan C Chilukuri | Student in an Organized Health Care Education/Training Program | Bronxcare Hospital Center, 1650 Grand Concourse, Bronx, NY 10457 | 2020-07-15 |
| 1003434457 | Nauri Estefani Abreu Roa | Student in an Organized Health Care Education/Training Program | Bronxlebanon Health System, 1650 Grand Concourse, Bronx, NY 10457 | 2020-07-13 |
| 1033737630 | Sapna Sharma | Student in an Organized Health Care Education/Training Program | St. Barnabas Hospital, 4422 Third Avenue Bronx, Bronx, NY 10457 | 2020-07-09 |
| 1194341081 | Asha Tadepalli | Optometrist | 1650 Selwyn Avenue, Suite 1c, Bronxcare Health System, Department of Ophthalmology, Bronx, NY 10457 | 2020-06-17 |
| 1578196549 | Ernesto Murray | Technician | 463 East 178st Apt#3b, Bronx New York, NY 10457 | 2020-02-19 |
| 1245891001 | Muhammad Shahzad | Student in an Organized Health Care Education/Training Program | St. Barnabas Health 4422 Third Avenue, Bronx, NY 10457 | 2019-06-24 |
| 1144886565 | Grant Joseph Gleason | Student in an Organized Health Care Education/Training Program | 4422 3rd Avenue St Barbabas Hospital Dept of Dentistry, Bronx, NY 10457 | 2019-05-10 |
| Find all providers in zip 10457 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1881177533 | Hudson River Healthcare, Inc. | Clinic/Center | 459 East 149th Street, The Hub Health Center, Bronx, NY 10455-1314 | 2018-09-10 |
| 1720561517 | Hudson River Healthcare, Inc. | Clinic/Center | 226 East 144th Street, Brightpoint Health Citiwide, Bronx, NY 10451-5909 | 2018-09-08 |
| 1023503927 | Urban Health Plan, Inc. | Clinic/Center | 1000 Jennings St, Bronx, NY 10460-6099 | 2018-06-25 |
| 1669912341 | Morris Heights Health Center, Inc. | Clinic/Center | 1227 Edward L Grant Hwy, Bronx Medical and Wellness Center, Bronx, NY 10452-3101 | 2017-03-01 |
| 1104374685 | Morris Heights Health Center, Inc. | Clinic/Center | 825 E 233rd St, Bronx, NY 10466-3203 | 2016-09-14 |
| 1790154466 | Damian Family Care Centers, Inc. | Clinic/Center | 2604 3rd Avenue, Bronx, NY 10454 | 2015-09-23 |
| 1659754885 | Union Community Health Center, Inc. | Clinic/Center | 2101 Quarry Road, Bronx, NY 10457-2594 | 2015-07-07 |
| 1740679695 | Care for The Homeless | Clinic/Center | 800 Barretto St, Bronx, NY 10474-5304 | 2015-01-15 |
| Find all providers in BRONX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.