NPIMap

Organization Active NPI

Soldiers & Sailors Memorial Hospital

Doing business as Soldiers & Sailors Hospital Swing

  • Medicare Defined Swing Bed Hospital Unit
  • Penn Yan, NY
National Provider Identifier
1093858896
Registry record updated Nov 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
SOLDIERS & SAILORS MEMORIAL HOSPITAL
Doing business as
Soldiers & Sailors Hospital Swing
Practice address
418 N Main St
Penn Yan, NY 14527-1070
Phone
(315) 787-4150
Fax
(315) 787-4794
NPI assigned
Feb 14, 2007
Last updated
Nov 13, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
SOLDIERS AND SAILORS MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 13, 2014

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

Authorized official

Name
Ms. Pamela E Johnson
Title
Treasurer & Cfo
Phone
(315) 787-4030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X NU Primary

Addresses

Primary practice location

418 N Main St
Penn Yan, NY 14527-1070

Mailing address

418 N Main St
Penn Yan, NY 14527-1070
Phone (315) 787-4150

Other identifiers 4

IdentifierTypeStateIssuer
00336498MedicaidNY
40OtherNYBLUE CROSS
106127ELOtherNYPREFERRED CARE
015005055OtherNYBLUE CHOICE

Other names 1

  • SOLDIERS & SAILORS HOSPITAL SWING Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061104000499 NY Part A Provider - Critical Access Hospital 0446164255 Practice locations: Penn Yan, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093858896. Details of each certification follow.

Hospital certification: CCN 33Z314

Legal name
SOLDIERS & SAILORS MEMORIAL HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Oct 17, 1916 in NY
Enrollment address
418 North Main Street
Penn Yan, NY 14527-1085

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

Other NPIs with the same Medicare PAC ID 7

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

National Provider Directory

National Provider Directory
Tax ID family
American Red Cross Bloo10 organizations share this tax ID, including this one
Part of
American Red Cross Bloo

Other organizations with this tax ID 9

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

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Kathi S Finizio Individual W-2 Managing EmployeeDirector Patient Financial Services Jun 23, 2013
Robert D Anderson Individual Corporate Director Sep 14, 2021
Craig Densmore Individual Corporate Director Sep 14, 2021
Chevanne Devaney Individual Corporate Director Sep 14, 2021
Jose Acevedo Individual Corporate Director Sep 14, 2021
Rodolfo Queiroz Individual Corporate Director Sep 14, 2021
James Cheney Individual Corporate Director Sep 14, 2021
Ryan Hallings Individual Corporate Director Sep 14, 2021
James Nardozzi Individual Corporate Director Sep 14, 2021
Scott a Mooney Individual Corporate Director Sep 14, 2021
James Adams Individual Corporate Director Apr 27, 2022
Susan Stork Individual Corporate Director Sep 14, 2021
Kylene Abraham Individual Corporate Director Sep 14, 2021
Thomas Burrall Individual Corporate Director Sep 14, 2021
Trisha Koczent Individual Corporate Director May 24, 2021
Ann H McMullen Individual Corporate Director Sep 14, 2021
Lance Ward Individual Corporate Director Sep 14, 2021
Phillip Beckley Individual Corporate Director Sep 14, 2021

Owners & managing parties with NPI records 4

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 1

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.

Affiliated clinicians 1

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": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415836800000",
    "number": "1093858896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 N MAIN ST",
            "city": "PENN YAN",
            "state": "NY",
            "postal_code": "145271070",
            "telephone_number": "315-787-4150",
            "fax_number": "315-787-4794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 N MAIN ST",
            "city": "PENN YAN",
            "state": "NY",
            "postal_code": "145271070",
            "telephone_number": "315-787-4150",
            "fax_number": "315-787-4794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLDIERS & SAILORS MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOLDIERS AND SAILORS MEMORIAL HOSPITAL",
        "enumeration_date": "2007-02-14",
        "last_updated": "2014-11-13",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "TREASURER & CFO",
        "authorized_official_telephone_number": "315-787-4030",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00336498",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "40",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "106127EL",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "015005055",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOLDIERS & SAILORS HOSPITAL SWING",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Penn Yan, NY

Sources for this page

Verify at the official NPI Registry.