NPIMap

Organization Active NPI

St Lukes Roosevelt Hospital Center

  • General Acute Care Hospital
  • New York, NY
National Provider Identifier
1104982917
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
7002032H Issued in NY
Legal business name
ST LUKES ROOSEVELT HOSPITAL CENTER
Practice address
1000 10TH Ave
Roosevelt Division
New York, NY 10019
Phone
(212) 523-4000
Fax
(212) 256-3594
NPI assigned
Dec 28, 2006
Last updated
Sep 21, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

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

Authorized official

Name
Mr. Debra Jaeger
Title
Sr Vice President
Phone
(646) 605-7350

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Psychiatric Hospital Unit 273R00000X 7002032H NY
Rehabilitation Hospital Unit 273Y00000X 7002032H NY
Substance Use Disorder Rehabilitation Hospital Unit 276400000X 7002032H NY
General Acute Care Hospital 282N00000X 7002032H NY Primary
Ambulance 341600000X 7002032H NY

Addresses

Primary practice location

1000 10TH Ave
Roosevelt Division
New York, NY 10019

Mailing address

160 Water St
24TH Floor
New York, NY 10038-4922
Phone (212) 256-3030

Other identifiers 4

IdentifierTypeStateIssuer
000559OtherNYBLUE CROSS
01650173MedicaidNY
00239247MedicaidNY
00354967MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090506000114 NY Part A Provider - Hospital 1355250788 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: New York, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104982917. Details of each certification follow.

Hospital certification: CCN 330046

Legal name
ST LUKES ROOSEVELT HOSPITAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Aug 30, 2024
Beds
1,028
Ownership / control type
Church
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1936 in NY
Enrollment address
1000 Tenth Avenue
New York, NY 10019-1147
Hospital subgroups
Acute care, Psychiatric unit, Rehabilitation unit

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

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Mount Sinai WestCCN 330046 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 25

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

NameRoleSinceShare
Eric Mindich Individual Corporate DirectorDirector Jan 1, 2015
Frank Bisignano Individual Corporate DirectorBoard of Directors Dec 24, 2019
John S Winkleman Individual Corporate DirectorDirector Jan 1, 2015
Susan Cullman Individual Corporate DirectorBoard of Directors Dec 24, 2019
Denis Donegan Individual Corporate OfficerVice President Jan 1, 2022 100%
W-2 Managing EmployeeVice President Jan 1, 2022 100%
Operational/Managerial ControlVice President Jan 1, 2022 100%
John a Levin Individual Corporate DirectorDirector Jan 1, 2015
Robert Savage Individual Corporate DirectorBoard of Directors Dec 24, 2019
Joel S. Ehrenkranz Individual Corporate DirectorBoard of Directors Dec 24, 2019
Richard a Friedman Individual Corporate DirectorBoard of Director Jan 1, 2022
James E Flynn Individual Corporate DirectorBoard of Directors Dec 24, 2019
Thomas W Strauss Individual Corporate Director Jan 1, 2015
Joel Picket Individual Corporate DirectorBoard of Directors Dec 24, 2019
James Neary Individual Corporate DirectorBoard of Directors Dec 24, 2019
William Wright Individual Corporate DirectorBoard of Directors Dec 24, 2019
Henry M Calderon Individual Corporate DirectorBoard of Directors Dec 24, 2019
James S Tisch Individual Corporate DirectorBoard of Directors Dec 24, 2019
John B Hess Individual Corporate DirectorDirector Jan 1, 2015
Steven Hochberg Individual Corporate DirectorDirector Jan 1, 2015
Peter W May Individual Corporate DirectorBoard of Director Jan 1, 2022
Judith O Rubin Individual Corporate Director Jan 1, 2015
Louis Pell Individual Corporate DirectorBoard of Directors Dec 24, 2019
Timothy Day Individual Corporate Director Apr 1, 2009
James Gogel Individual Corporate DirectorDirector Jan 1, 2015
Michael Zimmerman Individual Corporate DirectorBoard of Directors Dec 24, 2019
Michael Minikes Individual Corporate DirectorBoard of Directors Dec 24, 2019

Practitioners & affiliated clinicians

Practitioners 355

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 355

Affiliated clinicians 1,047

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

View all 1,047

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789948800000",
    "number": "1104982917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 WATER ST",
            "address_2": "24TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100384922",
            "telephone_number": "212-256-3030",
            "fax_number": "212-256-3594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 10TH AVE",
            "address_2": "ROOSEVELT DIVISION",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10019",
            "telephone_number": "212-523-4000",
            "fax_number": "212-256-3594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LUKES ROOSEVELT HOSPITAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A",
        "authorized_official_last_name": "JAEGER",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "SR VICE PRESIDENT",
        "authorized_official_telephone_number": "646-605-7350",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "NY",
            "license": "7002032H",
            "primary": false
        },
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "NY",
            "license": "7002032H",
            "primary": false
        },
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": "NY",
            "license": "7002032H",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NY",
            "license": "7002032H",
            "primary": true
        },
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NY",
            "license": "7002032H",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000559",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01650173",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00239247",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00354967",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.