NPIMap

Organization Active NPI

Westchester-Ellenville Hospital, Inc.

  • Critical Access Hospital
  • Ellenville, NY
National Provider Identifier
1073525341
Registry record updated Aug 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
WESTCHESTER-ELLENVILLE HOSPITAL, INC.
Practice address
10 Healthy Way
Ellenville, NY 12428
Phone
(845) 647-6400
Fax
(845) 210-3044
NPI assigned
Aug 13, 2006
Last updated
Aug 20, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2015

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

Authorized official

Name
Mr. Steven L. Kelley
Title
President & Ceo
Phone
(845) 647-6400

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X NU
Critical Access Hospital 282NC0060X NU Primary

Addresses

Primary practice location

10 Healthy Way
Ellenville, NY 12428

Mailing address

10 Healthy Way
Ellenville, NY 12428
Phone (845) 647-6400

Other identifiers 1

IdentifierTypeStateIssuer
02094860MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20081209000178 NY Part A Provider - Critical Access Hospital 5597656181 Receives reassigned benefits from 40 practitioners
Practice locations: Ellenville, NY
O20220827000206 NY Part A Provider - Critical Access Hospital 5597656181 Practice locations: Ellenville, NY

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1073525341. Details of each certification follow.

Hospital certification: CCN 331310

Legal name
WESTCHESTER-ELLENVILLE HOSPITAL INC
Doing business as
ELLENVILLE REGIONAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jul 16, 2004
Last certification
Nov 4, 2021
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Apr 12, 2000 in NY
Enrollment address
10 Healthy Way
Ellenville, NY 12428-5612

Hospital certification: CCN 33Z310

Legal name
WESTCHESTER-ELLENVILLE HOSPITAL INC
Doing business as
ELLENVILLE REGIONAL HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Apr 12, 2000 in NY
Enrollment address
10 Healthy Way
Ellenville, NY 12428-5612
Other Hospital Practice Location

Care Compare: Hospital

Medicare Care Compare
Listed as
Ellenville Regional HospitalCCN 331310 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

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
33D0163034Ellenville Regional Hospital10 Healthy Way, Ellenville, NY 12428ComplianceMar 26, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Neil Calman Individual Corporate DirectorBoard Member Apr 1, 2007
John B Gillette Individual Corporate DirectorSecretary Mar 7, 2007
Corporate DirectorSecretary of Board Mar 1, 2007
Myrna Jargowsky Individual Corporate DirectorVice-Chairperson Jun 1, 2008
Corporate DirectorVice-Chair Bod Jun 1, 2008
Julius a Collins Individual Corporate DirectorChairperson Apr 1, 2005
Corporate Director Mar 30, 2015
Julie Cohen Lonstein Individual Corporate DirectorBoard Member Dec 1, 2011
Corporate DirectorBoard Member Dec 1, 2001
Steven Kelley Individual Corporate OfficerPresident & Ceo Nov 12, 2008
W-2 Managing EmployeePresident and Ceo Nov 12, 2008
Corporate OfficerCeo & President Oct 10, 2008
Philip Coombe Individual Corporate DirectorBoard Member Jun 1, 2009
William D Brown Individual Corporate DirectorTreasurer Apr 1, 2006
Corporate DirectorTreasurer-Board of Directors Apr 1, 2006
Kristina Ursitti Individual Corporate DirectorDirector Nov 1, 2020
Robert W Rue Individual W-2 Managing EmployeeChief Financial Officer Apr 1, 2015
Corporate Officer Mar 30, 2015
W-2 Managing EmployeeChief Financial Officer Mar 30, 2015
Craig Lopez Individual Corporate DirectorDirector Sep 1, 2020
David Eikszta Individual Corporate DirectorBoard Member May 1, 2011

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 46

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 46

Affiliated clinicians 115

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 115

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440028800000",
    "number": "1073525341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 HEALTHY WAY",
            "city": "ELLENVILLE",
            "state": "NY",
            "postal_code": "12428",
            "telephone_number": "845-647-6400",
            "fax_number": "845-210-3044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 HEALTHY WAY",
            "city": "ELLENVILLE",
            "state": "NY",
            "postal_code": "12428",
            "telephone_number": "845-647-6400",
            "fax_number": "845-210-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTCHESTER-ELLENVILLE HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-13",
        "last_updated": "2015-08-20",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "845-647-6400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02094860",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellenville, NY

Sources for this page

Verify at the official NPI Registry.