NPIMap

Organization Active NPI

Alice Hyde Medical Center

  • Critical Access Hospital
  • Malone, NY
National Provider Identifier
1114954682
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
ALICE HYDE MEDICAL CENTER
Practice address
133 Park St
Malone, NY 12953-1220
Phone
(518) 481-2210
Fax
(518) 481-2662
NPI assigned
Jun 28, 2006
Last updated
Jul 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Authorized official

Name
Mr. Matej Kollar
Title
Cfo
Phone
(518) 481-8065

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU
General Acute Care Hospital 282N00000X 1624000H NY
Critical Access Hospital 282NC0060X NU Primary

Addresses

Primary practice location

133 Park St
Malone, NY 12953-1220

Mailing address

133 Park St
Malone, NY 12953-1220
Phone (518) 481-2210

Other identifiers 1

IdentifierTypeStateIssuer
00354114MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.cioxhealth.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service Other Ciox Health

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY7 enrollments

Enrollment records 7

Enrollment IDStateProvider typePAC IDDetails
O20031126000357 NY Part B Supplier - Clinic/Group Practice 4082525837 Receives reassigned benefits from 340 practitioners
1 other NPI on this enrollment
Practice locations: Malone, NY; St. Regis Falls, NY; St Regis Falls, NY; Moira, NY; Ft Covington, NY; Chateaugay, NY
O20181120001023 NY Part A Provider - Rural Health Clinic 4082525837 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Moira, NY
O20181120001537 NY Part A Provider - Rural Health Clinic 4082525837 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Chateaugay, NY
O20181120001811 NY Part A Provider - Rural Health Clinic 4082525837 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fort Covington, NY
O20181127000114 NY Part A Provider - Rural Health Clinic 4082525837 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Saint Regis Falls, NY
O20191203001059 NY Part A Provider - Rural Health Clinic 4082525837 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Malone, NY
O20230512000344 NY Part A Provider - Critical Access Hospital 4082525837 Receives reassigned benefits from 200 practitioners
Practice locations: Malone, NY

NPI to CCN mapping 6

The Medicare certification numbers (CCNs) connected to NPI 1114954682. Details of each certification follow.

Rural health clinic certification: CCN 333981

Legal name
ALICE HYDE MEDICAL CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 2, 2019
Last certification
Mar 11, 2025
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Apr 17, 1905 in NY
Enrollment address
969 State Route 11
Moira, NY 12957-2303
Related CCNs
331321

Rural health clinic certification: CCN 333980

Legal name
ALICE HYDE MEDICAL CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 2, 2019
Last certification
Mar 14, 2025
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Apr 17, 1905 in NY
Enrollment address
6087 State Route 11
Chateaugay, NY 12920-3212
Related CCNs
331321

Rural health clinic certification: CCN 333982

Legal name
ALICE HYDE MEDICAL CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 2, 2019
Last certification
Mar 12, 2025
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
577 County Route 1
Fort Covington, NY 12937-2805
Related CCNs
331321

Rural health clinic certification: CCN 333983

Legal name
ALICE HYDE MEDICAL CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 2, 2019
Last certification
Mar 13, 2025
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Apr 17, 1905 in NY
Enrollment address
76 N Main St
Saint Regis Falls, NY 12980-0207
Related CCNs
331321

Rural health clinic certification: CCN 333998

Legal name
ALICE HYDE MEDICAL CENTER
Doing business as
UNIVERSITY OF VERMONT ALICE HYDE MEDICAL CENTER MEDICAL PRACTICES
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 20, 2020
Last certification
Aug 18, 2023
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Apr 17, 1905 in NY
Enrollment address
15 4TH St
Malone, NY 12953-1340
Related CCNs
331321

Hospital certification: CCN 331321

Legal name
ALICE HYDE MEDICAL CENTER
Doing business as
THE UNIVERSITY OF VERMONT HEALTH NETWORK-ALICE HYDE MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Oct 1, 2023
Last certification
Oct 1, 2023
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Apr 13, 1905 in NY
Enrollment address
133 Park St
Malone, NY 12953-1244
Main/Primary Hospital Location

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

Other NPIs with the same Medicare PAC ID 3

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

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
The University of Vermont Health Network-Alice HyCCN 331321 · All quality measures
Overall star rating
1 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

183 Park St
Ste 4
Malone, NY 12953
Phone (518) 481-2401

20 4th St
#1
Malone, NY 12953
Phone (518) 481-2294

Ownership & related parties

All disclosed owners & managing parties 43

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

NameRoleSinceShare
Nathan Monette Individual Corporate DirectorAhmc Board of Trustees Dec 18, 2024
Corporate OfficerBoard Member Dec 18, 2024
Corporate Officer Dec 18, 2024
Kara Odom Walker Individual Corporate DirectorUvmhn Board of Trustees Jan 1, 2021
Heidi Melbostad Individual Corporate DirectorUvmhn Board of Trustees Jan 1, 2026
Thomas Fitzpatrick Individual Corporate DirectorVice-Chair, Ahmc Board of Trustees Sep 18, 2019
Corporate OfficerBoard Vice Chair/Treasurer Jun 1, 2022
Corporate Officer Jun 1, 2022
Joseph Donnery Individual Corporate DirectorUvmhn Board of Trustees Jan 1, 2026
Donna J Kissane Individual Corporate DirectorAhmc Board of Trustees Dec 18, 2019
Corporate Officer Jun 1, 2022
Lisa Mark Individual Operational/Managerial ControlCmo Feb 3, 2020
Corporate OfficerChief Medical Officer Jun 1, 2022
W-2 Managing EmployeeChief Medical Officer Jun 1, 2022
Operational/Managerial ControlChief Medical Officer Jun 1, 2022
Corporate Officer Jun 1, 2022
W-2 Managing Employee Jun 1, 2022
Operational/Managerial Control Jun 1, 2022
Matej Kollar Individual Corporate OfficerCfo Feb 1, 2023
W-2 Managing Employee Feb 1, 2023
Corporate OfficerCfo Sr Vice President Jan 1, 2024
Corporate OfficerCfo Senior Vice President Jan 1, 2024
Sarah Harm Individual Corporate DirectorUvmhn Board of Trustees Jan 1, 2026
Alyson Richards Individual Corporate DirectorUvmhn Board of Trustees Jan 1, 2026
Steven Cacchio Individual Corporate DirectorUvmhn Board of Trustees Jan 1, 2026
Marina Medved Individual Corporate DirectorAhmc Board of Trustees Dec 13, 2023
Dominic Eisinger Individual Corporate DirectorUvmhn Board of Trustees Jan 1, 2021
Noma Bennett Anderson Individual Corporate DirectorUvmhn Board of Trustees Jan 1, 2022
Jason Ellis Individual Corporate DirectorAhmc Board of Trustees Dec 16, 2020
Corporate Officer Jun 1, 2022
Sandra Kibuey Individual Corporate DirectorUvmhn Board of Trustees Jan 1, 2026
Colleen Marie Stone Individual W-2 Managing EmployeePatient Accounting Manager Jan 8, 2024
Richard L Page Individual Corporate DirectorUvmhn Board of Trustees Oct 1, 2018
Tom Golonka Individual Corporate DirectorUvmhn Board of Trustees Jan 1, 2020
Charles Wiebe Individual Corporate DirectorUvmhn Board of Trustees Jan 1, 2026
Michelle M Lebeau Individual Corporate OfficerPresident Apr 2, 2018
W-2 Managing EmployeePresident Apr 2, 2018
Corporate OfficerPresident/Ceo Oct 1, 2018
Corporate OfficerPresident Ceo Oct 1, 2018
Corporate OfficerPresident /Ceo Oct 1, 2018
Christine Peters Individual Corporate DirectorUvmhn Board of Trustees Jan 1, 2026
Dragos Banu Individual Corporate DirectorUvmhn Board of Trustees Jan 1, 2025
The University of Vermont Health Network Inc. Organization, Burlington, VT Corporation, Management services company, Holding company, Non-profit 5% Or Greater Direct Ownership Interest Oct 7, 2015 100%
Victoria Z Duley Individual Corporate DirectorUvmhn Board of Trustees Jan 1, 2020
Susan N Vogelzang Individual W-2 Managing EmployeeRevenue Cycle Manager Aug 13, 2020
W-2 Managing EmployeePatient Accounting Director Jan 8, 2024
W-2 Managing EmployeePatient Accounting Manager Jan 8, 2024
Barbara Montour Individual Corporate DirectorAhmc Board of Trustees Jun 24, 2021
Corporate Officer Jun 1, 2022
Craig W Richards Individual Corporate Director Mar 24, 2022
Corporate Officer Jun 1, 2022
Erica Metzger Hare Individual Corporate DirectorUvmhn Board of Trustees Jan 1, 2026
Hannah Busman Individual Corporate DirectorAhmc Board of Trustees Dec 18, 2024
Corporate OfficerBoard Member Dec 18, 2024
Elizabeth Vicencio Individual Corporate DirectorUvmhn Board of Trustees Jan 1, 2022
John James Dwyer Individual Corporate DirectorUvmhn Board of Trustees Jan 1, 2020
Robert G Main Individual Corporate DirectorChair, Ahmc Board of Trustees Apr 20, 2016
Corporate DirectorBoard Treasurer Oct 1, 2018
Corporate OfficerBoard Chair Apr 20, 2016
Kevin J Hart Individual Corporate DirectorAhmc and Uvmhn Board of Trustees Feb 24, 2016
Corporate DirectorBoard Vice-Chair Oct 1, 2018
Corporate DirectorBoard Vice Chair Oct 1, 2018
Tammy Reynolds Individual Corporate DirectorAhmc Board of Trustees Dec 18, 2024
Kelly a Beach Individual Operational/Managerial ControlDirector Practice Operations Oct 1, 2018
Marie Lefleur Individual W-2 Managing EmployeePractice Manager Feb 7, 2022
Stanley Yang Individual W-2 Managing EmployeeMD; Oct 1, 2025
Joshua L Frank Individual Corporate Officer Jun 1, 2022
Angela M Bashaw Individual Operational/Managerial ControlDirector Program/Support Oct 1, 2018
Operational/Managerial ControlDirector Programs/Support Oct 1, 2018
Shauna Miller Individual W-2 Managing EmployeeOffice Manager Apr 25, 2022
W-2 Managing EmployeeOffice Manager Jun 1, 2022
Robert Ramsey Herrington Individual Corporate OfficerBoard Member Dec 18, 2024
Emily E Campbell Individual Operational/Managerial ControlAvp Patient and People Experienc Oct 1, 2018

Owners & managing parties with NPI records 11

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

Facilities with the same owner 12

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

Practitioners & affiliated clinicians

Practitioners 354

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 354

Affiliated clinicians 315

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

View all 315

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751414400000",
    "number": "1114954682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 PARK ST",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "129531220",
            "telephone_number": "518-481-2210",
            "fax_number": "518-481-2818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 PARK ST",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "129531220",
            "telephone_number": "518-481-2210",
            "fax_number": "518-481-2662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALICE HYDE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-28",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A",
        "authorized_official_last_name": "KOLLAR",
        "authorized_official_first_name": "MATEJ",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "518-481-8065",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NY",
            "license": "1624000H",
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00354114",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.cioxhealth.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "esmd.cioxhealth.com and OID is '2.16.840.1.113883.3.6635.1.1'",
            "affiliationName": "Ciox Health",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "925 N Point Pkwy",
            "city": "Alpharetta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300055210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Malone, NY

Sources for this page

Verify at the official NPI Registry.