NPIMap

Organization Active NPI

Samaritan Medical Center

  • Rehabilitation Hospital Unit
  • Watertown, NY
National Provider Identifier
1093722068
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
License
2201000H Issued in NY
Legal business name
SAMARITAN MEDICAL CENTER
Practice address
830 Washington St
Watertown, NY 13601-4034
Phone
(315) 786-4800
NPI assigned
Aug 2, 2006
Last updated
Dec 15, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
SAMARITAN MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Authorized official

Name
Chris Hochgraf
Title
Director of Revenue Cycle
Phone
(315) 779-5278

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X 2201000H NY Primary

Addresses

Primary practice location

830 Washington St
Watertown, NY 13601-4034

Mailing address

830 Washington St
Watertown, NY 13601-4034
Phone (315) 786-4800

Other identifiers 1

IdentifierTypeStateIssuer
00354316MedicaidNY

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040227000525 NY Part B Supplier - Clinic/Group Practice 8123914876 Receives reassigned benefits from 218 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cape Vincent, NY; Watertown, NY; Evans Mills, NY; Clayton, NY; Adams, NY
O20121120000417 NY Part A Provider - Hospital 8123914876 Practice locations: Watertown, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093722068. Details of each certification follow.

Hospital certification: CCN 33T157

Legal name
SAMARITAN MEDICAL CENTER
Organization structure
CorporationNon-profit
Incorporated
Oct 1, 1881 in NY
Enrollment address
830 Washington St
Watertown, NY 13601-4034
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation unit

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

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Samaritan Medical CenterCCN 33T157 · All quality measures
Ownership
Non-profit
Certified
Jan 1, 1999

National Provider Directory

National Provider Directory
Part of
Medical Oncology

Member organizations 1

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

Locations

26908 Independence Way
Ste 100
Evans Mills, NY 13637
Phone (315) 629-4080

1575 Washington St
Watertown, NY 13601
Phone (315) 779-5060

19324 US Route 11
Watertown, NY 13601
Phone (315) 782-7230

22567 Summit Dr
Watertown, NY 13601
Phone (315) 779-6784

22567 Summit Dr
Bldg 2
Watertown, NY 13601
Phone (315) 779-6784

830 Washington St
#R
Watertown, NY 13601
Phone (315) 785-4000

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
John Wheeler Individual Corporate DirectorBoard Member Jan 1, 2023
Kimberly Laclair Individual Corporate DirectorBM Jan 1, 2023
Chris Hochgraf Individual Corporate DirectorBoard Member, DO Jan 1, 2023
Dierdra D Sorrell Individual Corporate DirectorBM Jan 1, 2023
John Patrick Barrett Individual Corporate DirectorBoard Member Jan 1, 2023
Kevin L Chandler Individual Corporate DirectorBoard Member Jan 1, 2023
Paul Barton Individual Corporate DirectorBoard Member Jan 1, 2023
Maxine a Briggs Individual Corporate DirectorBM, Ao, Cfo Jan 1, 2023
Joan Treadwell-Woods Individual Corporate DirectorBoard Member Jan 1, 2016
Al Maloney Individual Corporate DirectorBoard Member Jan 1, 2016
Mary Wardwell Donahue Individual Corporate DirectorBoard Member Jan 1, 2023
Denise Young Individual Corporate DirectorBM Jan 1, 2023
Marie Hess Individual Corporate DirectorBoard Member Jan 1, 2016
Jan Turcotte Individual Corporate DirectorBoard Member Apr 1, 2010
Timothy Virkler Individual Corporate DirectorBM Jan 1, 2023
Tracy Leonard Individual Corporate DirectorBM Jan 1, 2023
David Paul Rechlin Individual Corporate DirectorBoard Member Jan 1, 2016
Thomas H Carman Individual Corporate DirectorBoard Member Apr 1, 2010
W-2 Managing EmployeeCeo Apr 1, 2010 100%
Stephen Todd Individual Corporate DirectorBM Jan 1, 2023

Owners & managing parties with NPI records 3

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

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 106

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 106

Affiliated clinicians 3

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

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639526400000",
    "number": "1093722068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 WASHINGTON ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136014034",
            "telephone_number": "315-786-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 WASHINGTON ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136014034",
            "telephone_number": "315-786-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMARITAN MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAMARITAN MEDICAL CENTER",
        "enumeration_date": "2006-08-02",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A",
        "authorized_official_last_name": "HOCHGRAF",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "315-779-5278"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "NY",
            "license": "2201000H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00354316",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

Verify at the official NPI Registry.