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JERICHO ROAD COMMUNITY HEALTH CENTER
NPI 1952893091
Clinic/Center - Federally Qualified Health Center (FQHC) in Buffalo, NY

Active since June 05, 2018CLIA 33D2192904 · Microscopy
1021 BROADWAY ST, BUFFALO, NY 14212(716) 529-3020(716) 529-3040 Get Directions Write a Review

NPPES record last updated: August 23, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 23, 2021, Feb 28, 2020, Nov 26, 2018 and 1 more (4 updates tracked since 2018).

About Jericho Road Community Health Center NPPES

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

JERICHO ROAD COMMUNITY HEALTH CENTER (NPI 1952893091) is a healthcare organization registered as a federally qualified health center (fqhc) in Buffalo, New York and active in the NPI registry since June 2018. The organization holds a CLIA Microscopy certificate valid through March 26, 2027 and lists Jackie Endress, Credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1952893091
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameJERICHO ROAD MINISTRIES, INC.
Location Address1021 BROADWAY STBuffalo, NY 14212-1460
Mailing Address184 Barton StBuffalo, NY 14213-1573 · (716) 881-6191 · Fax (716) 881-6247
Phone(716) 529-3020
Fax(716) 529-3040
Organization SubpartYes
Authorized OfficialJackie EndressCredentialing Specialist · (716) 348-3000
Enumeration DateJune 5, 2018
Last NPPES UpdateAugust 23, 20214 updates tracked since enumeration
NPPES CertifiedAugust 23, 2021
✔ NPI 1952893091 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
License✔ Licensed in NY · 1401237R
1021 BROADWAY ST, Buffalo, NY 14212
Open in Google Maps ↗

Other Names 1

Doing Business AsJericho Road Community Health Center

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jericho Road Community Health Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

40

Medicare enrollment records show 40 clinicians reassign Medicare billing to Jericho Road Community Health Center, which bills Medicare for the services they deliver. Of these, 9 practice at this address and 35 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 9

Nurse Practitioner20
Family Practice13
Clinical Social Worker1
Dentist1
Internal Medicine1
Oral Surgery1
Orthopedic Surgery1
Pediatric Medicine1
1 other specialty1

Nearest to this location (20)

See all 40
Olayinka Adetimehin
Nurse Practitioner
NPI 1407496730
1021 BROADWAY ST FL 3
Buffalo, NY 14212
(716) 529-3020
✔ PECOS✔ Accepts MedicareSame address
Ashley Deluca, DO
Family Practice
NPI 1720607211
1021 BROADWAY ST
Buffalo, NY 14212
(716) 529-3020
✔ PECOS✔ Accepts MedicareSame address
Carla Henke, MD
Family Practice
NPI 1508023037
1021 BROADWAY ST
Buffalo, NY 14212
(716) 529-3020
✔ PECOS✔ Accepts MedicareSame address
Aung Thant, M.D.
Family Practice
NPI 1730522541
1021 BROADWAY ST
Buffalo, NY 14212
(716) 529-3020
✔ PECOS✔ Accepts MedicareSame address
Katherine Thomas, FNP
Nurse Practitioner
NPI 1497473359
1021 BROADWAY ST
Buffalo, NY 14212
(716) 529-3020
✔ PECOS✔ Accepts MedicareSame address
Brittany Wahl, FNP
Nurse Practitioner
NPI 1639067663
1021 BROADWAY ST FL 3
Buffalo, NY 14212
(716) 881-6191
✔ PECOS✔ Accepts MedicareSame address
Alexandra Yacub
Nurse Practitioner
NPI 1003523754
1021 BROADWAY ST
Buffalo, NY 14212
(716) 529-3020
✔ PECOS✔ Accepts MedicareSame address
Sandeep Arora, DMD
Dentist
NPI 1487371530
1021 BROADWAY ST
Buffalo, NY 14212
(716) 348-3018
✔ PECOSSame address
Crystal Devlin, FNP
Nurse Practitioner
NPI 1174827729
1021 BROADWAY ST
Buffalo, NY 14212
(716) 529-3020
✔ PECOSSame address
Demetra Mcilwain, MD
Family Practice
NPI 1871056002
21 DOAT ST
Buffalo, NY 14211
(716) 892-2775
✔ PECOS✔ Accepts Medicare1.4 mi
Daniel Smith, PHD, AGPCNP-BC, CNE
Nurse Practitioner
NPI 1902556848
100 E TUPPER ST
Buffalo, NY 14203
(716) 919-6870
✔ PECOS✔ Accepts Medicare1.6 mi
Abigail Grainge, FNP; PMHNP
Nurse Practitioner
NPI 1144707316
77 BROADWAY ST
Buffalo, NY 14203
(716) 834-6401
✔ PECOS✔ Accepts Medicare1.8 mi
Takesha Leonard, NP
Nurse Practitioner
NPI 1063744209
2495 MAIN ST STE 466
Buffalo, NY 14214
(716) 260-9320
✔ PECOS3.0 mi
Anthony Burdo, MD
Family Practice
NPI 1619590387
182 BRECKENRIDGE ST
Buffalo, NY 14213
(716) 881-6191
✔ PECOS✔ Accepts Medicare3.4 mi
Elizabeth Harding, MD
Family Practice
NPI 1184852840
184 BARTON ST
Buffalo, NY 14213
(716) 881-6191
✔ PECOS✔ Accepts Medicare3.4 mi
Sarah Milazzo, MD
Pediatric Medicine
NPI 1548602873
184 BARTON ST
Buffalo, NY 14213
(716) 881-6191
✔ PECOS3.4 mi
Oscar Prada Gonzalez, MSN FNP-C
Nurse Practitioner
NPI 1487597316
184 BARTON ST
Buffalo, NY 14213
(716) 881-6191
✔ PECOS3.4 mi
Megan Zbytek
Clinical Social Worker
NPI 1134858061
184 BARTON ST
Buffalo, NY 14213
(716) 881-6191
✔ PECOS3.4 mi
Myron Glick, MD
Family Practice
NPI 1730256942
184 BARTON ST
Buffalo, NY 14213
(716) 881-6191
✔ PECOS✔ Accepts Medicare3.4 mi
Fuad Sheriff, M.D.
Internal Medicine
NPI 1609855477
184 BARTON ST
Buffalo, NY 14213
(716) 881-6191
✔ PECOS3.4 mi
See all 40 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 for Provider-Performed Microscopy Procedures (PPMP) 33D2192904

Jericho Road Community Health Center · Buffalo, NY
Active · expires Mar 26, 2027
CLIA Number33D2192904
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateSeptember 16, 2020
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorDr. Carla R. Henke
Laboratory Phone(716) 529-3030
Laboratory LocationJericho Road Community Health Center1021 Broadway Street, Buffalo, NY 14212
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Medical Equipment Supplier Medicare DMEPOS 4

Medicare supplier enrollment and the product categories Jrchc Pharmacy @ Broadway carries, from the Medicare DMEPOS supplier directory.

Jrchc Pharmacy @ Broadway

DMEPOS supplier · Buffalo, NYOperated by Jericho Road Ministries Inc
✔

Accepts Medicare assignment

Jrchc Pharmacy @ Broadway agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20403419
Medicare Participant SinceDecember 20, 2021
Supplier Location1021 Broadway StBuffalo, NY 14212
Supplier Specialties
Pharmacy

Medicare Product Categories

Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Blood Glucose Monitors/Supplies (Non-Mail Order)
Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
Enteral Nutrients
Enteral formula
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

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 Jericho Road Ministries, Inc.'s NPI number?

The NPI number for Jericho Road Ministries, Inc. is 1952893091. It was assigned to this organization in the NPPES registry on June 5, 2018. The provider is doing business as Jericho Road Community Health Center.

Where is Jericho Road Ministries, Inc. located?

Jericho Road Ministries, Inc. is located at 1021 Broadway St, Buffalo, NY 14212. The listed phone number is (716) 529-3020.

What is Jericho Road Ministries, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Is Jericho Road Ministries, Inc. enrolled in Medicare?

Yes. Jericho Road Ministries, Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Jericho Road Ministries, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 40 clinicians in 9 Medicare specialties reassign their Medicare billing to Jericho Road Ministries, Inc.. 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 Nurse Practitioner (20), Family Practice (13) and Clinical Social Worker (1). Of these, 9 practice at this address and 35 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Jericho Road Ministries, Inc. accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Jrchc Pharmacy @ Broadway accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Jericho Road Ministries, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 33D2192904) is associated with this NPI, valid through March 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Jericho Road Ministries, Inc. accept?

Health plans from UnitedHealthcare list Jericho Road Ministries, Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jericho Road Ministries, Inc. was last updated on August 23, 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.