NPIMap

Organization Active NPI

Rochester General Hospital

Doing business as Rochester General Hospital-Psych

  • Psychiatric Hospital Unit
  • Rochester, NY
National Provider Identifier
1174620629
Registry record updated Jun 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
2701003H Issued in NY
Legal business name
ROCHESTER GENERAL HOSPITAL
Doing business as
Rochester General Hospital-Psych
Practice address
1425 Portland Ave
Rochester, NY 14621
Phone
(585) 922-4000
NPI assigned
Sep 19, 2006
Last updated
Jun 15, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2015

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

Authorized official

Name
Paula Tinch
Title
SVP-Finance
Phone
(585) 922-1223

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 2701003H NY Primary

Addresses

Primary practice location

1425 Portland Ave
Rochester, NY 14621

Mailing address

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-4000

Other identifiers 5

IdentifierTypeStateIssuer
XEOtherNYBLUE CROSS
000900001001OtherNYHEALTH NOW
00303315MedicaidNY
0120059XEOtherNYBLUE CHOICE
H020POtherNYPREFERRED CARE

Other names 1

  • Rochester General Hospital-Psych Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060927000116 NY Part A Provider - Hospital 0244149474 Practice locations: Rochester, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1174620629. Details of each certification follow.

Hospital certification: CCN 33S125

Legal name
ROCHESTER GENERAL HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Dec 28, 1951 in NY
Enrollment address
1425 Portland Ave
Rochester, NY 14621-3001
Hospital Psychiatric Unit
Hospital subgroups
General, Psychiatric, Rehabilitation, Other

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Tax ID family
Richard Stolarczyk31 organizations share this tax ID, including this one

Other organizations with this tax ID 30

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

View all 30

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Julia C Tedesco Individual Corporate DirectorBoard Secretary Jul 1, 2020
Marcy Cardona Mulconry Individual Corporate DirectorBoard Member Jul 1, 2020
Karen M Gallina Individual Corporate DirectorBoard Member Jul 1, 2014
Nichole S Holder Individual W-2 Managing EmployeeDirector Payor Enrollment Jul 1, 2020
Richard O Davis Individual Corporate OfficerCeo Mar 1, 2023
Ashley Peggs Individual W-2 Managing Employee Jun 1, 2024
Howard Glastonbury Individual Corporate OfficerVP Cfo Corporate Finance Jul 1, 2020
Amanda Wilson Individual W-2 Managing Employee Jun 1, 2024
Leon T Sawyko Individual Corporate DirectorBoard Member Jul 1, 2014
Linda S Becker Individual Corporate DirectorBoard Member Jun 1, 2009
Jeffrey C. Mapstone Individual Corporate DirectorBoard Member Jul 1, 2014
Thomas R Crilly Individual Corporate OfficerExecutive VP, Cfo Apr 1, 2015
W-2 Managing EmployeeExecutive VP, Cfo Apr 1, 2015

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1158624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434326400000",
    "number": "1174620629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 PORTLAND AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14621",
            "telephone_number": "585-922-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 PORTLAND AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14621",
            "telephone_number": "585-922-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCHESTER GENERAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-19",
        "last_updated": "2015-06-15",
        "status": "A",
        "authorized_official_last_name": "TINCH",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "SVP-FINANCE",
        "authorized_official_telephone_number": "585-922-1223"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "NY",
            "license": "2701003H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "XE",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NOW",
            "identifier": "000900001001",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00303315",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "0120059XE",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "H020P",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rochester General Hospital-Psych",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.