NPIMap

Organization Active NPI

Catholic Charities of the Diocese of Rockville Centre

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bay Shore, NY
National Provider Identifier
1124034558
Registry record updated Mar 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
6814100A Issued in NY
Legal business name
CATHOLIC CHARITIES OF THE DIOCESE OF ROCKVILLE CENTRE
Practice address
9 4TH Ave
Bay Shore, NY 11706-7908
Phone
(631) 665-6707
NPI assigned
Jul 31, 2006
Last updated
Mar 31, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2017

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

Authorized official

Name
Richard Balcom
Title
Cfo
Phone
(516) 733-7032

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 6814100A NY Primary

Addresses

Primary practice location

9 4TH Ave
Bay Shore, NY 11706-7908

Mailing address

90 Cherry LN
Hicksville, NY 11801-6232
Phone (516) 733-7040

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040721000332 NY Part B Supplier - Clinic/Group Practice 9436137908 Receives reassigned benefits from 28 practitioners
4 other NPIs on this enrollment
Practice locations: Medford, NY; Hampton Bays, NY; Bayshore, NY

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Tax ID family
Catholic Charities of the Diocese of Rockville Centre26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

Locations

9 4th Ave
Bay Shore, NY 11706
Phone (631) 665-6707

1727 N Ocean Ave
Medford, NY 11763
Phone (631) 684-1919

Practitioners & affiliated clinicians

Practitioners 41

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 41

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490918400000",
    "number": "1124034558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 CHERRY LN",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118016232",
            "telephone_number": "516-733-7040",
            "fax_number": "516-733-7098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 4TH AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117067908",
            "telephone_number": "631-665-6707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHOLIC CHARITIES OF THE DIOCESE OF ROCKVILLE CENTRE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2017-03-31",
        "status": "A",
        "authorized_official_last_name": "BALCOM",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "516-733-7032"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NY",
            "license": "6814100A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.