Active NPI
St Vincent de Paul Residence
- Skilled Nursing Facility
- Bronx, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 7000366N
- Legal business name
- ST VINCENT DE PAUL RESIDENCE
- Practice address
- 900 Intervale Avenue
Bronx, NY 10459 - Phone
- (917) 645-9201
- Fax
- (718) 589-7010
- NPI assigned
- Jan 12, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Annmarie Covone
- Title
- SRVP Cfo
- Phone
- (646) 633-4702
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 7000366N | NY | Primary |
Addresses
Primary practice location
900 Intervale Avenue
Bronx, NY 10459
Mailing address
900 Intervale Ave
Bronx, NY 10459-4240
Phone (646) 633-4774
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01367115 | Medicaid | NY | |
| 01446244 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090616000031 | NY | Part A Provider - Skilled Nursing Facility | 6406906387 | Practice locations: Bronx, NY |
Skilled nursing facility certification: CCN 335763
- Legal name
- ST VINCENT DE PAUL RESIDENCE
- Doing business as
- ARCHCARE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Oct 29, 1992
- Last certification
- Jan 8, 2025
- Beds
- 200
- Ownership / control type
- Nonprofit Corporation
- Multi-facility organization
- Catholic Hthcare D/B/A Archcare
- Organization structure
- Corporation
- Incorporated
- Feb 14, 1990 in NY
- Enrollment address
- 900 Intervale Ave
Bronx, NY 10459-4240 - Nursing home name
- ST VINCENT DEPAUL RESIDENCE
- Affiliated entity
- ARCHCARE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- St Vincent Depaul Residence
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Oct 29, 1992
- Medicare certification status
- Active
- Certified beds
- 200
- Chain
- Archcare
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 33D2060039 | Saint Vincent de Paul Residence Catholic Health | Certificate of waiver | Mar 26, 2027 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 28
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Richard Park | Corporate Director | Jan 2, 2024 | |
| William Whiston | Corporate Director | Jan 2, 2024 | |
| Joseph Saporito | Corporate Director | Jan 2, 2024 | |
| Tara a. Cortes | Corporate Director | May 1, 2014 | |
| Rory Kelleher | Corporate Director | Jun 2, 2009 | |
| Joseph P Lamorte | Corporate Director | Apr 4, 2019 | |
| Frank J Serbaroli | Corporate Director | Jun 2, 2009 | |
| Thomas J Fahey | Corporate Director | May 1, 2014 | |
| Eric P Feldmann | Corporate Director | May 1, 2014 | |
| Annmarie Covone | Corporate Officer | May 18, 2009 | |
| Operational/Managerial Control | May 18, 2009 | ||
| Cynthia Roberti | Corporate Director | Jan 2, 2024 | |
| Thomas M O'Brien | Corporate Director | May 1, 2014 | |
| Gemma Augustine | Operational/Managerial Control | Jan 2, 2024 | |
| Patricia Tooker | Corporate Director | Jan 2, 2024 | |
| Stephen J Bujno | Corporate Director | Jan 2, 2024 | |
| Eunice Richards | Operational/Managerial Control | Feb 22, 2022 | |
| Adp of the SNF | Feb 13, 2025 | ||
| John Cahill | Corporate Director | Jan 2, 2024 | |
| Gerald T Walsh | Corporate Director | Jan 2, 2024 | |
| Gerald T Sweeney | Corporate Director | May 1, 2014 | |
| Catholic Health Care Systems | Operational/Managerial Control | Apr 1, 2005 | |
| Leslie Kasergrande | Corporate Director | Jan 2, 2024 | |
| Karen a Gray | Corporate Director | Jan 2, 2024 | |
| Thomas E Alberto | Corporate Director | May 1, 2014 | |
| John F Gleason | Corporate Director | Jan 2, 2024 | |
| Scott Larue | Corporate Officer | Nov 21, 2014 | |
| Operational/Managerial Control | Jan 1, 2024 | ||
| Kathryn K Rooney | Corporate Director | May 1, 2014 | |
| Hammad M Rizvi | Operational/Managerial Control | Jan 2, 2024 | |
| Adp of the SNF | Feb 18, 2025 | ||
| Clarion E Johnson | Corporate Director | Jan 2, 2024 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- New York, NY
- NPI 1659516227
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 6
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Calvary Hospital Hospice
- Community Based Hospice Care Agency
- Bronx, NY
- NPI 1396756524
Catholic Health Care Systems
-
dba Carmel Richmond Health Care and Rehabilitation Center
- Skilled Nursing Facility
- Staten Island, NY
- NPI 1023097698
Catholic Health Care Systems
-
- Skilled Nursing Facility
- Rhinebeck, NY
- NPI 1083693576
Catholic Health Care Systems
-
- Skilled Nursing Facility
- New York, NY
- NPI 1598744146
Catholic Health Care Systems
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Bronx, NY
- NPI 1861460818
-
- General Practice Physician
- Bronx, NY
- NPI 1902944408
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137024000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1206057600000",
"number": "1053390534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 INTERVALE AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104594240",
"telephone_number": "646-633-4774"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 INTERVALE AVENUE",
"city": "BRONX",
"state": "NY",
"postal_code": "10459",
"telephone_number": "917-645-9201",
"fax_number": "718-589-7010"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ST VINCENT DE PAUL RESIDENCE",
"organizational_subpart": "NO",
"enumeration_date": "2006-01-12",
"last_updated": "2008-03-21",
"status": "A",
"authorized_official_last_name": "COVONE",
"authorized_official_first_name": "ANNMARIE",
"authorized_official_title_or_position": "SRVP CFO",
"authorized_official_telephone_number": "646-633-4702"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NY",
"license": "7000366N",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01367115",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01446244",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bronx, NY
- Katia St Jean, LPN
- Stephania St Jean
- Maxine St Louis, MS, CCC-SLP
- Ronald St Louis, MD
- St Sebastian Medical PC
- St, Barnabas Anesthesia Associates
- St, Michael Physical Therapy PC
- St. Ann's Corner of Harm Reduction
- St. Barnabas (Physicians of St. Barnabas Hospital/Internal Medicine)
- St. Barnabas Anesthesia Associates, P.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.