NPIMap

Organization Active NPI

Bronxcare Health System

  • Psychiatric Hospital Unit
  • Bronx, NY
National Provider Identifier
1083796213
Registry record updated May 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
7000001H Issued in NY
Legal business name
BRONXCARE HEALTH SYSTEM
Practice address
1276 Fulton Ave
Bronx, NY 10456
Phone
(718) 901-8600
Fax
(718) 293-1475
NPI assigned
Oct 19, 2006
Last updated
May 30, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2018

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

Authorized official

Name
Mr. Victor G Demarco, CPA
Title
Senior VP-Chief Financial Officer
Phone
(718) 901-8600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 7000001H NY Primary

Addresses

Primary practice location

1276 Fulton Ave
Bronx, NY 10456

Mailing address

1276 Fulton Ave
Bronx, NY 10456-3402
Phone (718) 901-8600

Other identifiers 2

IdentifierTypeStateIssuer
00476022MedicaidNY
000163NOtherNYBLUE CROSS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111221000461 NY Part A Provider - Hospital 3870404429 Practice locations: Bronx, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083796213. Details of each certification follow.

Hospital certification: CCN 33S009

Legal name
BRONXCARE HEALTH SYSTEM
Organization structure
CorporationNon-profit
Incorporated
Nov 8, 1962 in NY
Enrollment address
1276 Fulton Ave
Bronx, NY 10456-3467
Main/Primary Hospital Location
Hospital subgroups
Psychiatric

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Tax ID family
BLHC OBGYN GRP28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Dormitory Authority of the State of New York Organization, Albany, NY Created for acquisition 5% Or Greater Mortgage Interest Jan 18, 2007
David Gomez Individual Corporate DirectorBoard Member Jan 2, 2020
Barbara a Lowe Individual Corporate DirectorBoard Member Oct 10, 2000
Steven Landgraber Individual Corporate DirectorBoard Member Jan 2, 2020
TD Bank N.a. Organization, Lewiston, ME Created for acquisition, Financial institution 5% Or Greater Mortgage Interest Feb 26, 2009
Fredrick Gilbert Individual Corporate DirectorBoard Member Jan 2, 2020
Luis Francisco Individual W-2 Managing EmployeeIt Manager Oct 3, 2016
John R Colon Individual Corporate DirectorBoard Member Jan 9, 2007
Milagros Baez O'Toole Individual Corporate DirectorBoard Member Jan 1, 2013
Miguel Fuentes Individual Corporate OfficerPresident and Ceo May 6, 1987
Corporate DirectorBoard Member May 6, 1987
William Aguado Individual Corporate DirectorBoard Member Jan 2, 2020
Cristina Toosie Individual Corporate DirectorBoard Member Jan 9, 1990
Victor G Demarco Individual Corporate OfficerSVP & Cfo Nov 1, 1999
W-2 Managing EmployeeSVP & Cfo Nov 1, 1999
Ricardo R. Fernandez Individual Corporate DirectorBoard Member May 12, 1992
Rita Dimartino Individual Corporate DirectorBoard Member Sep 15, 1987

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527638400000",
    "number": "1083796213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 FULTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563402",
            "telephone_number": "718-901-8600",
            "fax_number": "718-293-1475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276 FULTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10456",
            "telephone_number": "718-901-8600",
            "fax_number": "718-293-1475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRONXCARE HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2018-05-30",
        "status": "A",
        "authorized_official_last_name": "DEMARCO",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "SENIOR VP-CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "718-901-8600",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "NY",
            "license": "7000001H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00476022",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000163N",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.