River Hospital, Inc.
Organization Active NPI Critical Access Hospital · Alexandria Bay, NY
NPI 1003814641 · NPPES record last updated Sep 13, 2022
Key facts
- NPI
- 1003814641
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Access Hospital 282NC0060X
- License
- 2221700C (NY)
- Legal business name
- RIVER HOSPITAL, INC.
- Practice address
- 4 Fuller St
Alexandria Bay, NY 13607-1316 - Phone
- (315) 482-2511
- Fax
- (315) 482-4981
- NPI assigned
- Jul 8, 2005
- Organization subpart
- No
Authorized official
- Name
- Emily Mastaler
- Title
- Ceo
- Phone
- (315) 286-9003
Other NPIs on the same Medicare enrollment 2
Other NPIs with the same Medicare PAC ID 2
Related certifications (CCN) 2
Practitioners 117
-
Christopher F. Brandy, M.D.P.C.
-
Kiri Pryjma Brandy, M.D.
-
Amit Goyal, M.D.
-
Jie He, MD
-
Michael L Kehoe, MSW
-
Jade Marie McKnight, LCSW
-
Matthew Bonner McLain, ACNP-BC
-
Mursel Momand, MD
-
Bruce Stephen Portner, M.D.
-
Fritz Roc, M.D.
-
Frederic D. Seifer, M.D.
-
Brian Thomas Zafonte, M.D., PH.D.
-
Lourdes Sofia Fulcomer, FNP-C
-
Zakir Hussain, M.D.
-
Melany S Rookstool, M.D.
-
David Christopher Gordon, PH.D., M.D.
-
Joanne Atkinson, PA
-
David N Bailey, PA
Affiliated clinicians 129
-
Marta M Anghel, MD
-
David H Antecol, MD
-
Joanne Atkinson, PA
-
Bruce L Baird, M.D.
-
Scott D Beeles, RPA
-
Christopher F. Brandy, M.D.P.C.
-
Kiri Pryjma Brandy, M.D.
-
Justin Budnik, M.D.
-
Brett R Bunker, P.A.
-
Aaliya Burza, M.D.
-
Biren V Chokshi, M.D.
-
Tony C.Y. Chuang, M.D.
-
Michael T Clarke, MD
-
James T Connelly, MD
-
Ryan Connolly, PA
-
Alexandra Davies, R.P.A.
Medicare Care Compare: Hospital
- Listed as
- River Hospital Clinics
- Type
- Critical Access Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in NY
Hospital certification: CCN 33Z309
- Legal name
- RIVER HOSPITAL INC
- Organization structure
- Corporation · Non-profit
- Incorporated
- Apr 15, 2003 in NY
- Enrollment address
- 4 Fuller St
Alexandria Bay, NY 13607-1316
Hospital certification: CCN 331309
- Legal name
- RIVER HOSPITAL INC
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- Jul 25, 2003
- Last certification
- Aug 6, 2021
- Beds
- 24
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation · Non-profit
- Incorporated
- Apr 15, 2003 in NY
- Enrollment address
- 4 Fuller St
Alexandria Bay, NY 13607-1316
All disclosed owners & managing parties 7
| Name | Role | Since | Share |
|---|---|---|---|
| Norman Snyder |
Corporate Director | Mar 1, 2008 | |
| Other | May 1, 2001 | ||
| Jolene Rosenbarker |
W-2 Managing Employee |
Jul 20, 2021 | |
| Brooke Parmeter |
W-2 Managing Employee |
Feb 1, 2012 | |
| Kelley M Tiernan |
Corporate Officer |
Sep 1, 2020 | |
| Emily Mastaler |
Corporate Officer |
Sep 28, 2019 | |
| Corporate Officer |
Sep 28, 2019 | ||
| Nellie Taylor |
Corporate Director | Jun 5, 2003 | |
| Carrie B Bova |
W-2 Managing Employee |
Jul 1, 2015 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040614001352 | NY | Part B Supplier - Clinic/Group Practice | 2567372899 |
Receives reassigned benefits from 110 practitioners 1 other NPI on this enrollment Practice locations: Alex Bay, NY |
| O20061104000153 | NY | Part a Provider - Critical Access Hospital | 2567372899 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Alexandria Bay, NY |
| O20061104000154 | NY | Part a Provider - Critical Access Hospital | 2567372899 |
1 other NPI on this enrollment Practice locations: Alexandria Bay, NY |
National Provider Directory
Locations
6 Fuller St
Alexandria Bay, NY 13607
Phone (315) 482-1125
6B Fuller St
Alexandria Bay, NY 13607
Phone (315) 482-2094
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Access Hospital | 282NC0060X | 2221700C | NY | Yes |
| Critical Access Hospital | 282NC0060X | 2221001N | NY |
Addresses
Primary practice location
4 Fuller St
Alexandria Bay, NY 13607-1316
Mailing address
4 Fuller St
Alexandria Bay, NY 13607-1316
Phone (315) 482-2511
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02392854 | Medicaid | NY |
Other names
- Swing Bed Program
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://hie.healtheconnections.org/#/healthe-login | Health Information Exchange (HIE) | |
| CONNECT URL | https://hie.healtheconnections.org/#/healthe-login | Health Information Exchange (HIE) |
Other providers in Alexandria Bay, NY
- Natalie Kathryn Powers
- Jessica Lauren Rafter
- Natalie Ramsdell
- Mahreen Abdul Razzaq
- Rhody L Spooner Optical Services
- River Hospital, Inc.
- River Hospital, Inc.
- River Hospital, Inc.
- River Hospital, Inc.
- River Hospital, Inc.
All providers in Alexandria Bay, NY · Critical Access Hospital in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.