NPIMap

Organization Active NPI

St. Camillus Residential Health Care Facility

  • Case Management Agency
  • Syracuse, NY
National Provider Identifier
1053452656
Registry record updated Sep 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
TBI00076 Issued in NY
Legal business name
ST. CAMILLUS RESIDENTIAL HEALTH CARE FACILITY
Practice address
813 Fay Rd
Syracuse, NY 13219-3009
Phone
(315) 488-2951
Fax
(315) 488-7734
NPI assigned
Feb 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Michael Zingaro
Title
Cfo
Phone
(315) 703-0646

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X TBI00076 NY Primary
Community/Behavioral Health Agency 251S00000X TBI00076 NY

Addresses

Primary practice location

813 Fay Rd
Syracuse, NY 13219-3009

Mailing address

813 Fay Rd
Syracuse, NY 13219-3009
Phone (315) 488-2951

Other identifiers 1

IdentifierTypeStateIssuer
01585359MedicaidNY

Other names 1

  • St. Camillus TBI Waiver Services Other name

National Provider Directory

National Provider Directory
Tax ID family
St Camillus Residential Health Care Facility5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474243200000",
    "number": "1053452656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 FAY RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132193009",
            "telephone_number": "315-488-2951",
            "fax_number": "315-488-7734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 FAY RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132193009",
            "telephone_number": "315-488-2951",
            "fax_number": "315-488-7734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. CAMILLUS RESIDENTIAL HEALTH CARE FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2016-09-19",
        "status": "A",
        "authorized_official_last_name": "ZINGARO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "315-703-0646",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NY",
            "license": "TBI00076",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NY",
            "license": "TBI00076",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01585359",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Camillus TBI Waiver Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.