NPIMap

Organization Active NPI

Clinton County

  • Clinic/Center
  • Plattsburgh, NY
National Provider Identifier
1114979945
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
0901200R Issued in NY
Legal business name
CLINTON COUNTY
Practice address
133 Margaret Street
Plattsburgh, NY 12901
Phone
(518) 565-4840
Fax
(518) 565-4717
NPI assigned
May 17, 2006
Organization subpart
Yes
Parent organization
CLINTON COUNTYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Authorized official

Name
Maria Cadieux
Title
Health Facility Comptroller
Phone
(518) 565-3284

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 09012008 NY
Clinic/Center 261Q00000X 0901200R NY Primary

Addresses

Primary practice location

133 Margaret Street
Plattsburgh, NY 12901

Mailing address

133 Margaret St FL 3
Plattsburgh, NY 12901-2926
Phone (518) 565-4840

Other identifiers 1

IdentifierTypeStateIssuer
00583757MedicaidNY

Other names 1

  • Clinton County Health Department Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120320000012 NY Part B Supplier - Mass Immunization (Roster Biller Only) 7618960600 Practice locations: Plattsburgh, NY

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Part of
Clinton County Health Department

Locations

133 Margaret St
Plattsburgh, NY 12901
Phone (518) 565-4840

130 Arizona Ave
Ste 1500
Plattsburgh, NY 12903
Phone (518) 565-4060

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Clinton County Nursing HomePlattsburgh, NY, CCN 335598 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Jan 1, 1978
Jan 1, 1978
Jan 1, 1978

Owned or controlled facilities with NPI records 1

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

  • Clinton County
    • Skilled Nursing Facility
    • Plattsburgh, NY
    • NPI 1992854103

    5% Or Greater Direct Ownership Interest, Adp of the SNF, Operational/Managerial Control

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 49

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

View all 49

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729814400000",
    "number": "1114979945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 MARGARET ST FL 3",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129012926",
            "telephone_number": "518-565-4840",
            "fax_number": "518-565-4717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 MARGARET STREET",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "12901",
            "telephone_number": "518-565-4840",
            "fax_number": "518-565-4717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINTON COUNTY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLINTON COUNTY",
        "enumeration_date": "2006-05-17",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A",
        "authorized_official_last_name": "CADIEUX",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "HEALTH FACILITY COMPTROLLER",
        "authorized_official_telephone_number": "518-565-3284"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NY",
            "license": "09012008",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NY",
            "license": "0901200R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00583757",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinton County Health Department",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clinton County Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plattsburgh, NY

Sources for this page

Verify at the official NPI Registry.