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Organization Active NPI

Kaleida Health

  • General Acute Care Hospital
  • North Tonawanda, NY
National Provider Identifier
1104956358
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
KALEIDA HEALTH
Practice address
445 Tremont St
North Tonawanda, NY 14120
Phone
(719) 694-4500
NPI assigned
Mar 6, 2007
Organization subpart
Yes
Parent organization
KALEIDA HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Authorized official

Name
Angela H McCrorey
Title
Ar Manager
Phone
(716) 859-8313

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X NY Primary

Addresses

Primary practice location

445 Tremont St
North Tonawanda, NY 14120

Mailing address

726 Exchange St Ste 300
Buffalo, NY 14210-1467
Phone (716) 859-8396

Other identifiers 1

IdentifierTypeStateIssuer
03499910MedicaidNY

Other names 1

  • DEGRAFF HOSPITAL Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031105000212 NY Part B Supplier - Clinic/Group Practice 7810805280 Receives reassigned benefits from 712 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Buffalo, NY; N Tonawanda, NY; New York, NY; North Tonawanda, NY; Olean, NY; Pleasantville, NY; Poughkeepsie, NY; Williamsville, NY…
O20040324000835 NY Part A Provider - Hospital 7810805280 5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Buffalo, NY; Williamsville, NY; North Tonawanda, NY

Hospital certification: CCN 330005

Legal name
KALEIDA HEALTH
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Sep 23, 2022
Beds
986
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
100 High St
Buffalo, NY 14203-1126
Main/Primary Hospital Location
Hospital subgroups
General

Hospital certification: CCN 330007

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
DEGRAFF MEMORIAL HOSPITAL
Certification status
Terminated Voluntary: merger or closure, Apr 1, 1998
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Oct 23, 1992
Beds
155
Ownership / control type
Other
Most recent change of ownership
Apr 1, 1998 (1 total)
Facility address
445 Tremont St
North Tonawanda, NY 14120

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

Other NPIs on the same Medicare enrollment 9

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Kaleida HealthCCN 330005
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Mary George31 organizations share this tax ID, including this one
Part of
Mary George

Other organizations with this tax ID 30

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

View all 30

Locations

3900 Union Rd
Ste 600
Buffalo, NY 14225

2290 Delaware Ave
Buffalo, NY 14216

564 Niagara St
Ste 10
Buffalo, NY 14201

1001 Main St
Fl 2
Buffalo, NY 14203
Phone (716) 323-6410

100 High St
#1
Buffalo, NY 14203

6363 Transit Rd
Ste 510
Depew, NY 14043

5844 Southwestern Blvd
Ste 200
Hamburg, NY 14075

605 Division St
North Tonawanda, NY 14120
Phone (716) 693-2464

5959 Big Tree Rd
Ste 101
Orchard Park, NY 14127
Phone (716) 810-7997

Ownership & related parties

All disclosed owners & managing parties 32

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

NameRoleSinceShare
Matthew D Drake Individual Corporate OfficerEvp Strategy & Partnerships Dec 5, 2021
W-2 Managing EmployeeChief Financial Officer Dec 5, 2021
Timothy M. Adams Individual Corporate DirectorBoard Member Dec 1, 2023
Corin Silvestrini Individual W-2 Managing EmployeePayer Credentialing Supervisor Feb 1, 2024
Mary Lou Rusin Individual Corporate Director May 1, 2015
Ian Barrett Individual Corporate OfficerChief Human Resources Officer Oct 1, 2022
Jo Ann Ormond Individual W-2 Managing EmployeeDirector Patient Financial Services Aug 19, 2019
Donald Boyd Individual Corporate OfficerPresident, Chief Executive Officer Jul 11, 2022
Corporate DirectorBoard Member Jul 11, 2022
W-2 Managing EmployeePresident, Chief Executive Officer May 1, 2009
Paul O'Leary Individual Corporate Director Apr 1, 2018
Jennifer Dunn Individual W-2 Managing EmployeeRegional Contracting Director Mar 1, 2024
Timothy G McEvoy Individual Corporate DirectorBoard Member Jun 1, 2019
Kenneth V Snyder Individual W-2 Managing EmployeeChief Physician Quality Officer Apr 1, 2022
Michael P Hughes Individual Corporate OfficerSenior VP, Chief Admin Officer Sep 1, 2004
Prudential Huntoon Paige Associated LTD Isaoa Organization, Dallas, TX Financial institution 5% Or Greater Mortgage Interest Apr 1, 1998 33%
K Kent Chevli Individual Corporate DirectorBoard Member Apr 1, 2022
George E Matthews Individual Corporate Director May 1, 2008
Shannon Bryant Individual Corporate OfficerChief Diversity & Inclusion Officer Dec 1, 2020
Alyson Spaulding Individual Corporate OfficerGeneral Counsel Aug 1, 2014
Jamie N Nadler Individual W-2 Managing EmployeeChief Quality Officer May 1, 2022
Thomas Beauford Individual Corporate DirectorBoard Member Apr 12, 2022
Christopher D Ross Individual Corporate Director May 1, 2015
Lorrie Clemo Individual Corporate DirectorBoard Member May 1, 2017
Abeer Eddib Individual Corporate DirectorBoard Member Jun 1, 2019
Dan Magnuszewski Individual Corporate DirectorBoard Member Apr 1, 2024
Kaleida Health Organization, Buffalo, NY Corporation, Non-profit 5% Or Greater Direct Ownership Interest Apr 1, 1998 100%
Michael J Mineo Individual Corporate OfficerChief Medical Officer Oct 1, 2023
John Persons Individual Corporate Director Apr 1, 2022
Gary Crosby Individual Corporate DirectorBoard Chairman May 1, 2017
Marjorie Quint-Bouzid Individual Corporate OfficerChief Nurse Executive Oct 1, 2023
Muhammed Javed Individual Corporate DirectorBoard Member May 1, 2019
Hugh Chisholm Individual Corporate OfficerEvp, Cfo Oct 18, 2023
Michael McMahon Individual Corporate DirectorBoard Member Dec 1, 2023
Angela McCrorey Individual W-2 Managing EmployeeSupervisor Patient Financial Servic Jun 1, 2019

Owners & managing parties with NPI records 17

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

View all 17

Practitioners & affiliated clinicians

Practitioners 30

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

View all 30

Affiliated clinicians 1,723

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

View all 1,723

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690416000000",
    "number": "1104956358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 EXCHANGE ST STE 300",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142101467",
            "telephone_number": "716-859-8396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 TREMONT ST",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "14120",
            "telephone_number": "719-694-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KALEIDA HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KALEIDA HEALTH",
        "enumeration_date": "2007-03-06",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A",
        "authorized_official_last_name": "MCCROREY",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "AR MANAGER",
        "authorized_official_telephone_number": "716-859-8313"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03499910",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DEGRAFF HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DEGRAFF HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Tonawanda, NY

Sources for this page

Verify at the official NPI Registry.