NPIMap

Organization Active NPI

Cornell University

  • Student Health Clinic/Center
  • Ithaca, NY
National Provider Identifier
1073584926
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
CORNELL UNIVERSITY
Practice address
110 Ho Plaza
Ithaca, NY 14853
Phone
(607) 255-5155
Fax
(607) 255-0269
NPI assigned
Jan 30, 2006
Last updated
Oct 11, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Authorized official

Name
Jada Hamilton, MDNPI 1972610137
Title
Director
Phone
(607) 255-7492

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X Primary

Addresses

Primary practice location

110 Ho Plaza
Ithaca, NY 14853

Mailing address

110 Ho Plaza
Ithaca, NY 14853
Phone (607) 255-5155

Other names 3

  • Gannett Health Services Former legal business name
  • Cornell Health Other name
  • Gannett Cornell University Health Services Pharmacy Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231101003611 NY Part B Supplier - Clinic/Group Practice 0446604979 Receives reassigned benefits from 1 practitioner
Practice locations: Ithaca, NY

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
33D0707337Cornell Health Point of Care Testing110 Ho Plaza, Ithaca, NY 14853ComplianceMar 26, 2027

National Provider Directory

National Provider Directory
Tax ID family
College of Veterinary Medicine5 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.

Practitioners & affiliated clinicians

Practitioners 93

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 93

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696982400000",
    "number": "1073584926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HO PLAZA",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "14853",
            "telephone_number": "607-255-5155",
            "fax_number": "607-255-0269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HO PLAZA",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "14853",
            "telephone_number": "607-255-5155",
            "fax_number": "607-255-0269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNELL UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-30",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A",
        "authorized_official_last_name": "HAMILTON",
        "authorized_official_first_name": "JADA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "607-255-7492",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gannett Health Services",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Gannett Health Services",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Cornell Health",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Gannett Cornell University Health Services Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.