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Organization Active NPI

Saint Marys Hospital for Children Inc.

  • Pediatric Skilled Nursing Facility
  • Bayside, NY
National Provider Identifier
1083837157
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Skilled Nursing FacilityTaxonomy code 3140N1450X
Legal business name
SAINT MARYS HOSPITAL FOR CHILDREN INC.
Practice address
2901 216TH St
Bayside, NY 11360-2810
Phone
(718) 281-8800
NPI assigned
Apr 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Authorized official

Name
Celia M Cannata
Title
Billing Manager
Phone
(718) 281-8877

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 7003901L NY
Medically Fragile Infants and Children Day Care 261QM3000X
Pediatric Skilled Nursing Facility 3140N1450X Primary

Addresses

Primary practice location

2901 216TH St
Bayside, NY 11360-2810

Mailing address

2901 216TH St
Bayside, NY 11360-2810
Phone (718) 281-8800

Other identifiers 1

IdentifierTypeStateIssuer
00310985MedicaidNY

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170608000230 NY Part A Provider - Skilled Nursing Facility 3779663463 Practice locations: Bayside, NY
O20190730000066 NY Part B Supplier - Clinic/Group Practice 3779663463 Receives reassigned benefits from 3 practitioners
Practice locations: Bayside, NY

Skilled nursing facility certification: CCN 335875

Legal name
SAINT MARYS HOSPITAL FOR CHILDREN INC
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1888 in NY
Enrollment address
2901 216TH St
Bayside, NY 11360-2810

National Provider Directory

National Provider Directory
Tax ID family
St Mary'S Hospital for Children15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
William Mead Individual Corporate OfficerCfo/Coo Dec 1, 2014
Anthony Coniglio Individual Corporate DirectorBoard Member Jan 1, 2012
Stephen Brent Wells Individual Corporate DirectorBoard Member Jan 1, 2000
Vivian Figueroa Individual W-2 Managing EmployeeLNH - Administrator Feb 5, 2012
Adam Waxer Individual Corporate OfficerCompliance Officer Mar 16, 2015
Samuel Karetsky Individual Corporate OfficerBoard Member Jan 1, 2007
Edwin F Simpser Individual Corporate OfficerPresident & Ceo Sep 20, 2013
Cindy Johnson Individual Corporate DirectorBoard Member Jan 1, 2000

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601942400000",
    "number": "1083837157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 216TH ST",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113602810",
            "telephone_number": "718-281-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 216TH ST",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113602810",
            "telephone_number": "718-281-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT MARYS HOSPITAL FOR CHILDREN INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A",
        "authorized_official_last_name": "CANNATA",
        "authorized_official_first_name": "CELIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "718-281-8877"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": "7003901L",
            "primary": false
        },
        {
            "code": "261QM3000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medically Fragile Infants and Children Day Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00310985",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

Verify at the official NPI Registry.