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CONCOURSE MEDICAL CENTER INC
NPI 1073722286
Clinic/Center - Methadone in Bronx, NY

Active since May 22, 2007CLIA 33D2200970 · Waiver
880 MORRIS AVE, BRONX, NY 10451(718) 665-9340 Get Directions Write a Review

NPPES record last updated: July 9, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 9, 2021, Mar 12, 2019, Nov 19, 2015 (3 updates tracked since 2015).

About Concourse Medical Center Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CONCOURSE MEDICAL CENTER INC (NPI 1073722286) is a healthcare organization registered as a methadone in Bronx, New York and active in the NPI registry since May 2007. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Ana Matos, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1073722286
Entity TypeOrganization
Primary Taxonomy261QM2800X
Legal Business NameCONCOURSE MEDICAL CENTER INC
Location Address880 MORRIS AVEBronx, NY 10451-3412
Mailing Address880 Morris AveBronx, NY 10451-3412 · (718) 665-9340 · Fax (718) 665-2394
Phone(718) 665-9340
Organization SubpartNo
Authorized OfficialAna MatosExecutive Director · (718) 665-9340
Enumeration DateMay 22, 2007
Last NPPES UpdateJuly 9, 20213 updates tracked since enumeration
NPPES CertifiedJuly 9, 2021
✔ NPI 1073722286 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · MethadoneAmbulatory Health Care Facilities
Taxonomy Code261QM2800X
License✔ Licensed in NY · 090111295
Definition
An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.
880 MORRIS AVE, Bronx, NY 10451
Open in Google Maps ↗

Other Identifiers 3

OtherA400073294NY · Medicare
Medicaid02243034NY
OtherA300233658NY · Medicare

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D2200970

Concourse Medical Center Inc · Bronx, NY
Active · expires Mar 26, 2027
CLIA Number33D2200970
Laboratory TypeComp. Outpatient Rehab Facility
Certificate Effective DateNovember 18, 2020
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorDr. Ann Boyer
Laboratory Phone(718) 665-9340
Laboratory LocationConcourse Medical Center Inc880 Morris Ave, Bronx, NY 10451
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatm G2067
Medication Assisted Treatment (MAT) with methadone is a comprehensive approach to manage opioid addiction. It includes weekly methadone dispensing, substance use counseling, individual and group therapy sessions, and toxicology tests as needed, all provided by a Medicare-enrolled opioid treatment program.
184 services14 patients

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANA MERCEDES MATOS
Counselor (Addiction (Substance Use Disorder))
880 MORRIS AVE
BRONX, NY 10451
Bronx County (718) 665-9340
EFRAIN TORRES
Counselor (Addiction (Substance Use Disorder))
880 MORRIS AVE
BRONX, NY 10451
Bronx County (718) 665-9340
LAURENCE GELLER
Behavior Analyst
880 MORRIS AVE
BRONX, NY 10451
Bronx County (718) 665-9340
MARITZA MONSERRAT LPN
Licensed Practical Nurse
880 MORRIS AVE
BRONX, NY 10451
Bronx County (718) 665-9340
MS. YANIRA DELIA MORALES
Counselor (Addiction (Substance Use Disorder))
880 MORRIS AVE
BRONX, NY 10451
Bronx County (718) 665-9340
JESSE PAEZ
Marriage & Family Therapist
880 MORRIS AVE
BRONX, NY 10451
Bronx County (718) 665-9340
JEANETTE PEREZ
Counselor (Addiction (Substance Use Disorder))
880 MORRIS AVE
BRONX, NY 10451
Bronx County (718) 665-9340
ERIC BENITEZ
Licensed Practical Nurse
880 MORRIS AVE
BRONX, NY 10451
Bronx County (818) 855-4903

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Concourse Medical Center Inc's NPI number?

The NPI number for Concourse Medical Center Inc is 1073722286. It was assigned to this organization in the NPPES registry on May 22, 2007.

Where is Concourse Medical Center Inc located?

Concourse Medical Center Inc is located at 880 Morris Ave, Bronx, NY 10451. The listed phone number is (718) 665-9340.

What is Concourse Medical Center Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Methadone, with taxonomy code 261QM2800X.

Does Concourse Medical Center Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2200970) is associated with this NPI, valid through March 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Concourse Medical Center Inc was last updated on July 9, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.