NPIMap

Organization Active NPI

Little Falls Hospital

Doing business as Little Falls Hospital St Johnsville Health Center

  • Rural Health Clinic/Center
  • St Johnsville, NY
National Provider Identifier
1104473990
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
LITTLE FALLS HOSPITAL
Doing business as
Little Falls Hospital St Johnsville Health Center
Practice address
8 Park PL
St Johnsville, NY 13452-1332
Phone
(518) 568-3403
Fax
(518) 568-3216
NPI assigned
Aug 26, 2019
Last updated
Mar 4, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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

Authorized official

Name
James Vielkind
Title
Vice President Finance
Phone
(315) 823-5281

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

8 Park PL
St Johnsville, NY 13452-1332

Mailing address

140 Burwell Street
Little Falls, NY 13365-1725
Phone (315) 823-5281

Other names 1

  • Little Falls Hospital St Johnsville Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200124000946 NY Part A Provider - Rural Health Clinic 3678550837 Practice locations: St Johnsville, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104473990. Details of each certification follow.

Rural health clinic certification: CCN 333993

Legal name
LITTLE FALLS HOSPITAL
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 22, 2019
Last certification
Feb 12, 2025
Ownership / control type
2B
Most recent change of ownership
Dec 19, 2019 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Mar 23, 1894 in NY
Enrollment address
8 Park PL
St Johnsville, NY 13452-1332
Related CCNs
331311

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
Bassett Healthcare Delanson38 organizations share this tax ID, including this one

Other organizations with this tax ID 37

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

View all 37

Ownership & related parties

All disclosed owners & managing parties 36

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

NameRoleSinceShare
Gerard Snyder Individual Corporate OfficerSecretary Jun 1, 2010
Corporate DirectorBoard Member Jul 15, 2004
Laura Powers Individual Corporate OfficerFourth Vice Chairman Jan 1, 2023
Corporate Director Jul 30, 2020
Susan a Oakes Ferucci Individual Contracted Managing EmployeeChief Hospital Executive Jan 1, 2023
Anthony Deluca Individual Corporate OfficerFirst Vice Chairman Jun 1, 2001
Corporate DirectorBoard Member Jul 15, 2014
Mary Imogene Bassett Hospital Organization, Cooperstown, NY Corporation, Non-profit Operational/Managerial Control Oct 1, 2004
Phyllis Spinner Individual Corporate DirectorBoard Member Apr 1, 2016
David Casullo Individual Corporate OfficerChairman Jan 1, 2023
Corporate DirectorTrustee Jul 26, 2019
James G Vielkind Individual Contracted Managing EmployeeVice President Finance Feb 1, 2019
Corporate OfficerVice President Finance Aug 7, 2000
Operational/Managerial ControlVice President Finance Feb 1, 2019
Bassett Healthcare Network Organization, Cooperstown, NY Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jun 11, 2019 100%
5% Or Greater Direct Ownership Interest Jul 3, 2019 100%
Timothy Daly Individual Corporate OfficerTreasurer Jan 1, 2018
Corporate DirectorBoard Member Jun 1, 2010
Justin Hummel Individual Corporate OfficerSecond Vice Chairman Jan 1, 2017
Corporate DirectorBoard Member Jun 1, 2011
Christine Reynolds Individual Corporate OfficerThird Vice Chairman Jan 1, 2019
Corporate DirectorBoard Member Jun 1, 2018
Ashley Holmes Individual W-2 Managing EmployeeDirector Oct 1, 2024
Terry Fulmer Individual Corporate DirectorBoard Member Apr 1, 2019 100%
Walter a Franck Individual Corporate DirectorBoard Member Apr 1, 2019 100%
Glenn a Perrone Individual Corporate DirectorBoard Member Apr 1, 2019 100%
John D Bullis Individual Corporate DirectorBoard Member Apr 1, 2019 100%
Donald Q Quest Individual Corporate DirectorBoard Member Apr 1, 2019 100%
Douglas B Willies Individual Corporate DirectorBoard Member Apr 1, 2019 100%
Donald R Bordley Individual Corporate DirectorBoard Member Apr 1, 2019 100%
Jane Clark ( Forbes) Individual Corporate OfficerBoard Member Apr 1, 2019 100%
Corporate DirectorBoard Member Apr 1, 2019 100%
Richard C Vanison Individual Corporate DirectorBoard Member Apr 1, 2019 100%
Paul G Swinko Individual Corporate OfficerVice President Finance Apr 1, 2019 100%
W-2 Managing EmployeeVice President Finance Apr 1, 2019 100%
Lois Larsen Individual W-2 Managing EmployeeDirector Jul 1, 2019 100%
Edward Marryott Individual W-2 Managing EmployeeNetwork Vice President Revenue C Apr 1, 2019 100%
Robert S Hanft Individual Corporate DirectorBoard Member Apr 1, 2019 100%
Maureen a Killackey Individual Corporate DirectorBoard Member Apr 1, 2019 100%
J Michael Moffat Individual Corporate DirectorBoard Member Apr 1, 2019 100%
Bruce C Vladeck Individual Corporate DirectorBoard Member Apr 1, 2019 100%
Steven J Heneghan Individual W-2 Managing EmployeeBoard Member Apr 1, 2019 100%
William W Lecates Individual W-2 Managing EmployeeBoard Member and President Apr 1, 2019 100%
Peter J Hamilton Individual W-2 Managing EmployeeChief Clinical Officer Apr 1, 2019 100%
James K Patrick Individual Corporate DirectorBoard Member Apr 1, 2019 100%
Edward W Stack Individual Corporate DirectorBoard Member Apr 1, 2019 100%
Katherine G Nickerson Individual Corporate DirectorBoard Member Apr 1, 2019 100%
Richard a Polin Individual Corporate DirectorBoard Member Apr 1, 2019 100%

Owners & managing parties with NPI records 9

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Little Falls HospitalDolgeville, NY, CCN 333984 Rural health clinic Operational/Managerial Control (100%) Oct 4, 1993

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 13

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 13

Change-of-ownership history 1

DateEventCounterparty
Dec 19, 2019 Change of OwnershipThis provider was the buyer Mary Imogene Bassett HospitalCCN 333993, NY, NPI 1780600577

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Practitioners 20

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 20

NPI Registry JSON

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

{
    "created_epoch": "1566777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583280000000",
    "number": "1104473990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 BURWELL STREET",
            "city": "LITTLE FALLS",
            "state": "NY",
            "postal_code": "133651725",
            "telephone_number": "315-823-5281",
            "fax_number": "315-823-5383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 PARK PL",
            "city": "ST JOHNSVILLE",
            "state": "NY",
            "postal_code": "134521332",
            "telephone_number": "518-568-3403",
            "fax_number": "518-568-3216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE FALLS HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-26",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A",
        "authorized_official_last_name": "VIELKIND",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "VICE PRESIDENT FINANCE",
        "authorized_official_telephone_number": "315-823-5281"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Little Falls Hospital St Johnsville Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Johnsville, NY

Sources for this page

Verify at the official NPI Registry.