PASSPORT HEALTH
NPI 1104524925
Community Health Worker in Carle Place, NY
NPI Status: Active since February 21, 2023
Contact Information
1 OLD COUNTRY ROAD
SUITE 272
CARLE PLACE, NY
ZIP 11514
Phone: (844) 358-8648
Fax: (877) 877-6875
- Organization
- Community Health Worker
- CLIA Number: 10D2240320
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 10-18-2025
About PASSPORT HEALTH
This page provides the complete NPI Profile along with additional information for Passport Health, a provider established in Carle Place, New York operating as a Community Health Worker. The healthcare provider is registered in the NPI registry with number 1104524925 assigned on February 2023. The practitioner's primary taxonomy code is 172V00000X. The provider is registered as an organization and their NPI record was last updated 3 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Passport Health. The authorized official of this NPI record is Sarah Rapier (Medical Billing Specialist)
- NPI
- 1104524925
- Provider Legal Name
- CDA MEDICAL, PLLC
- Other Organization Name
- PASSPORT HEALTH
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1 OLD COUNTRY ROAD SUITE 272 CARLE PLACE, NY 11514
- Location Phone
- (844) 358-8648
- Location Fax
- (877) 877-6875
- Mailing Address
- 4343 EAST OUTLIER BLV. SUITE 100W PHOENIX, AZ 85008
- Mailing Phone
- (844) 358-8648
- Mailing Fax
- (877) 877-6875
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 02-21-2023
- Last Update Date
- 06-03-2023
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Community Health Worker
- Taxonomy Code
- 172V00000X
- Type
- Other Service Providers
- Taxonomy Description
- Community health workers (CHW) are lay members of communities who work either for pay or as volunteers in association with the local health care system in both urban and rural environments and usually share ethnicity, language, socioeconomic status and life experiences with the community members they serve. They have been identified by many titles such as community health advisors, lay health advocates, promotores(as), outreach educators, community health representatives, peer health promoters, and peer health educators. CHWs offer interpretation and translation services, provide culturally appropriate health education and information, assist people in receiving the care they need, give informal counseling and guidance on health behaviors, advocate for individual and community health needs, and provide some direct services such as first aid and blood pressure screening. Some examples of these practitioners are Community Health Aides or Practitioners established under 25 USC 1616 (l) under HHS, Indian Health Service, Public Health Service.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 2083P0901X | Allopathic & Osteopathic Physicians | Preventive Medicine |
Group Taxonomy 193400000X MULTIPLE SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 10D2240320
- Facility Type
- Physician Office
- Certificate Effective Date
- October 19, 2023
- Certificate Expiration Date
- October 18, 2025
- Laboratory Director
- WALTER B. KANE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Passport Health to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1104524925, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 55 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1104524925, enumerated as an "organization" on February 21, 2023.
The provider is located at 1 OLD COUNTRY ROAD SUITE 272 CARLE PLACE, NY 11514 and the phone number is (844) 358-8648.
Community Health Worker with taxonomy code 172V00000X.
