NPIMap

Little Falls Hospital

Organization Active NPI Rural Health Clinic/Center · St Johnsville, NY

NPI 1104473990 · NPPES record last updated Mar 4, 2020

Key facts

NPI
1104473990
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
LITTLE FALLS HOSPITAL
Practice address
8 Park PL
St Johnsville, NY 13452-1332
Phone
(518) 568-3403
Fax
(518) 568-3216
NPI assigned
Aug 26, 2019
Organization subpart
No

Authorized official

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

Owners & managing parties with NPI records 9

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

Owned or controlled facilities with NPI records 1

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

Other NPIs with the same Medicare PAC ID 7

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

Corporate family (same tax ID) 36

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

View all 36

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

Change of ownership 1

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

Facilities with the same owner 13

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

Practitioners 25

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY

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
Corporation · Non-profit
Incorporated
Mar 23, 1894 in NY
Enrollment address
8 Park PL
St Johnsville, NY 13452-1332
Related CCNs
331311

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 Officer
Secretary		 Jun 1, 2010
Corporate Director
Board Member		 Jul 15, 2004
Laura Powers
Individual 		Corporate Officer
Fourth Vice Chairman		 Jan 1, 2023
Corporate Director Jul 30, 2020
Susan a Oakes Ferucci
Individual 		Contracted Managing Employee
Chief Hospital Executive		 Jan 1, 2023
Anthony Deluca
Individual 		Corporate Officer
First Vice Chairman		 Jun 1, 2001
Corporate Director
Board Member		 Jul 15, 2014
Mary Imogene Bassett Hospital
Organization · Cooperstown, NY
Corporation, Non-profit 		Operational/Managerial Control Oct 1, 2004
Phyllis Spinner
Individual 		Corporate Director
Board Member		 Apr 1, 2016
David Casullo
Individual 		Corporate Officer
Chairman		 Jan 1, 2023
Corporate Director
Trustee		 Jul 26, 2019
James G Vielkind
Individual 		Contracted Managing Employee
Vice President Finance		 Feb 1, 2019
Corporate Officer
Vice President Finance		 Aug 7, 2000
Operational/Managerial Control
Vice 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 Officer
Treasurer		 Jan 1, 2018
Corporate Director
Board Member		 Jun 1, 2010
Justin Hummel
Individual 		Corporate Officer
Second Vice Chairman		 Jan 1, 2017
Corporate Director
Board Member		 Jun 1, 2011
Christine Reynolds
Individual 		Corporate Officer
Third Vice Chairman		 Jan 1, 2019
Corporate Director
Board Member		 Jun 1, 2018
Ashley Holmes
Individual 		W-2 Managing Employee
Director		 Oct 1, 2024
Terry Fulmer
Individual 		Corporate Director
Board Member		 Apr 1, 2019 100%
Walter a Franck
Individual 		Corporate Director
Board Member		 Apr 1, 2019 100%
Glenn a Perrone
Individual 		Corporate Director
Board Member		 Apr 1, 2019 100%
John D Bullis
Individual 		Corporate Director
Board Member		 Apr 1, 2019 100%
Donald Q Quest
Individual 		Corporate Director
Board Member		 Apr 1, 2019 100%
Douglas B Willies
Individual 		Corporate Director
Board Member		 Apr 1, 2019 100%
Donald R Bordley
Individual 		Corporate Director
Board Member		 Apr 1, 2019 100%
Jane Clark ( Forbes)
Individual 		Corporate Officer
Board Member		 Apr 1, 2019 100%
Corporate Director
Board Member		 Apr 1, 2019 100%
Richard C Vanison
Individual 		Corporate Director
Board Member		 Apr 1, 2019 100%
Paul G Swinko
Individual 		Corporate Officer
Vice President Finance		 Apr 1, 2019 100%
W-2 Managing Employee
Vice President Finance		 Apr 1, 2019 100%
Lois Larsen
Individual 		W-2 Managing Employee
Director		 Jul 1, 2019 100%
Edward Marryott
Individual 		W-2 Managing Employee
Network Vice President Revenue C		 Apr 1, 2019 100%
Robert S Hanft
Individual 		Corporate Director
Board Member		 Apr 1, 2019 100%
Maureen a Killackey
Individual 		Corporate Director
Board Member		 Apr 1, 2019 100%
J Michael Moffat
Individual 		Corporate Director
Board Member		 Apr 1, 2019 100%
Bruce C Vladeck
Individual 		Corporate Director
Board Member		 Apr 1, 2019 100%
Steven J Heneghan
Individual 		W-2 Managing Employee
Board Member		 Apr 1, 2019 100%
William W Lecates
Individual 		W-2 Managing Employee
Board Member and President		 Apr 1, 2019 100%
Peter J Hamilton
Individual 		W-2 Managing Employee
Chief Clinical Officer		 Apr 1, 2019 100%
James K Patrick
Individual 		Corporate Director
Board Member		 Apr 1, 2019 100%
Edward W Stack
Individual 		Corporate Director
Board Member		 Apr 1, 2019 100%
Katherine G Nickerson
Individual 		Corporate Director
Board Member		 Apr 1, 2019 100%
Richard a Polin
Individual 		Corporate Director
Board Member		 Apr 1, 2019 100%

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 Hospital
Dolgeville, NY · CCN 333984		 Rural health clinic Operational/Managerial Control (100%) Oct 4, 1993

Change-of-ownership history

DateEventCounterparty
Dec 19, 2019 Change of Ownership
This provider was the buyer		 Mary Imogene Bassett Hospital
CCN 333993 · NY · NPI 1780600577

Medicare enrollment records

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

National Provider Directory

Tax ID family
Bassett Physician GRP (37 organizations share this tax ID)

Locations

544 E Main St
West Winfield, NY 13491
Phone (315) 822-6238

Specialties & licenses

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

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

  • Little Falls Hospital St Johnsville Health Center Doing business as

Other providers in St Johnsville, NY

All providers in St Johnsville, NY · Rural Health Clinic/Center in New York

Sources for this page

Verify at the official NPI Registry.