Organization Active NPI

St Vincent de Paul Residence

  • Skilled Nursing Facility
  • Bronx, NY
National Provider Identifier
1053390534
Registry record updated Mar 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
7000366N Issued in NY
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

Updated by the provider on Mar 21, 2008

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
01367115MedicaidNY
01446244MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
CorporationNon-profit
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 ResidenceCCN 335763 · All quality measures
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Oct 29, 1992
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
20059.5 residents per day on average
Chain
Archcare7 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2060039Saint Vincent de Paul Residence Catholic Health900 Intervale Avenue, Bronx, NY 10459Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

Ownership & 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.

NameRoleSinceShare
Richard Park Individual Corporate DirectorTrustee Jan 2, 2024
William Whiston Individual Corporate DirectorTrustee Jan 2, 2024
Joseph Saporito Individual Corporate DirectorTrustee Jan 2, 2024
Tara a. Cortes Individual Corporate DirectorSecretary May 1, 2014
Rory Kelleher Individual Corporate DirectorTrustee Jun 2, 2009
Joseph P Lamorte Individual Corporate DirectorTrustee Apr 4, 2019
Frank J Serbaroli Individual Corporate DirectorChairman Jun 2, 2009
Thomas J Fahey Individual Corporate DirectorTrustee May 1, 2014
Eric P Feldmann Individual Corporate DirectorTrustee May 1, 2014
Annmarie Covone Individual Corporate OfficerExex. Vice President May 18, 2009
Operational/Managerial Control May 18, 2009
Cynthia Roberti Individual Corporate DirectorTrustee Jan 2, 2024
Thomas M O'Brien Individual Corporate DirectorVice-Chair May 1, 2014
Gemma Augustine Individual Operational/Managerial Control Jan 2, 2024
Patricia Tooker Individual Corporate DirectorTrustee Jan 2, 2024
Stephen J Bujno Individual Corporate DirectorTrustee Jan 2, 2024
Eunice Richards Individual Operational/Managerial Control Feb 22, 2022
Adp of the SNF Feb 13, 2025
John Cahill Individual Corporate DirectorTrustee Jan 2, 2024
Gerald T Walsh Individual Corporate DirectorTrustee Jan 2, 2024
Gerald T Sweeney Individual Corporate DirectorTrustee May 1, 2014
Catholic Health Care Systems Organization, New York, NY Non-profit Operational/Managerial Control Apr 1, 2005
Leslie Kasergrande Individual Corporate DirectorTrustee Jan 2, 2024
Karen a Gray Individual Corporate DirectorTrustee Jan 2, 2024
Thomas E Alberto Individual Corporate DirectorTrustee May 1, 2014
John F Gleason Individual Corporate DirectorTrustee Jan 2, 2024
Scott Larue Individual Corporate OfficerCeo Nov 21, 2014
Operational/Managerial Control Jan 1, 2024
Kathryn K Rooney Individual Corporate DirectorTrustee May 1, 2014
Hammad M Rizvi Individual Operational/Managerial Control Jan 2, 2024
Adp of the SNF Feb 18, 2025
Clarion E Johnson Individual Corporate DirectorTrustee 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.

Facilities with the same owner 6

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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

Sources for this page

Verify at the official NPI Registry.