NORTHEAST COMMUNITY CENTER FOR MENTAL HEALTH-MENTAL RETARDATION I
NPI 1306907704
Clinic/Center - Adult Mental Health in Philadelphia, PA
About Northeast Community Center For Mental Health-mental Retardation I NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NORTHEAST COMMUNITY CENTER FOR MENTAL HEALTH-MENTAL RETARDATION I (NPI 1306907704) is a healthcare organization registered as an adult mental health in Philadelphia, Pennsylvania and active in the NPI registry since December 2006. The organization lists David Como, Executive Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 3
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Northeast Community Center For Mental Health-mental Retardation I is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
8Medicare enrollment records show 8 clinicians reassign Medicare billing to Northeast Community Center For Mental Health-Mental Retardation I, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 8 within 10 miles. They are listed nearest first.
Clinicians, nearest first (8)
Philadelphia, PA 19124
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Northeast Community Center For Mental Health-Mental Retardation I's NPI number?
The NPI number for Northeast Community Center For Mental Health-Mental Retardation I is 1306907704. It was assigned to this organization in the NPPES registry on December 12, 2006.
Where is Northeast Community Center For Mental Health-Mental Retardation I located?
Northeast Community Center For Mental Health-Mental Retardation I is located at 4641 Roosevelt Blvd, Philadelphia, PA 19124. The listed phone number is (215) 831-2800.
What is Northeast Community Center For Mental Health-Mental Retardation I's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Adult Mental Health, with taxonomy code 261QM0850X.
Is Northeast Community Center For Mental Health-Mental Retardation I enrolled in Medicare?
Yes. Northeast Community Center For Mental Health-Mental Retardation I is registered in the Medicare PECOS enrollment system.
When is Northeast Community Center For Mental Health-Mental Retardation I's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Pennsylvania, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Northeast Community Center For Mental Health-Mental Retardation I?
According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians in 2 Medicare specialties reassign their Medicare billing to Northeast Community Center For Mental Health-Mental Retardation I. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Clinical Social Worker (4) and Psychiatry (4). Of these, 1 practice at this address and 8 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Northeast Community Center For Mental Health-Mental Retardation I was last updated on July 9, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.
# Northeast Community Center For Mental Health-Mental Retardation I · NPI 1306907704
Adult Mental Health organization in Philadelphia, Pennsylvania. Organization record, active in the CMS NPPES registry since December 12, 2006.
## Identity
- **NPI:** 1306907704 (Entity type: Organization)
- **Enumerated:** December 12, 2006
- **Primary specialty:** Clinic/Center - Adult Mental Health · taxonomy 261QM0850X
- **Organization subpart:** No
- **Authorized official:** David Como, EXECUTIVE DIRECTOR
## Practice location
- **Address:** 4641 ROOSEVELT BLVD, Philadelphia, PA 19124-2343
- **Phone:** (215) 831-2800 · **Fax:** (215) 831-2929
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, Pennsylvania, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 8 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Clinical Social Worker (4), Psychiatry (4); 1 practice at this address and 8 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 9, 2014
- **Other identifiers:** Other 769146 (PA); Other 169773 (PA); Medicaid 1000034170051 (PA)
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Source: [NPI Profile](https://npiprofile.com/npi/1306907704) · Data from the CMS NPPES public registry.