NPIMap

Organization Active NPI

Sun River Health Inc

  • Federally Qualified Health Center (FQHC)
  • Staten Island, NY
National Provider Identifier
1184107963
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
5901200R Issued in NY
Legal business name
SUN RIVER HEALTH INC
Practice address
56 Bay Street
Brightpoint 56 Bay Street Outpatient Treatment
Staten Island, NY 10301-2563
Phone
(718) 808-1439
Fax
(718) 808-1393
NPI assigned
Sep 8, 2018
Last updated
Mar 14, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
SUN RIVER HEALTH INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

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

Authorized official

Name
Adam Lipton
Title
VP Info/Practice MGMT Systems
Phone
(914) 384-2375

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 5901200R NY Primary

Addresses

Primary practice location

56 Bay Street
Brightpoint 56 Bay Street Outpatient Treatment
Staten Island, NY 10301-2563

Mailing address

PO Box 5036
White Plains, NY 10602-5036
Phone (914) 734-8800

Other identifiers 2

IdentifierTypeStateIssuer
W38731OtherNYGROUP MEDICARE
00473038MedicaidNY

Other names 1

  • Brightpoint 56 Bay Street Outpatient Treatment Other name

National Provider Directory

National Provider Directory
Tax ID family
Michael J Gallina17 organizations share this tax ID, including this one
Part of
Michael J Gallina

Other organizations with this tax ID 16

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

View all 16

Locations

56 Bay St
Staten Island, NY 10301
Phone (718) 808-1420

NPI Registry JSON

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

{
    "created_epoch": "1536364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647216000000",
    "number": "1184107963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5036",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106025036",
            "telephone_number": "914-734-8800",
            "fax_number": "914-734-8786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 BAY STREET",
            "address_2": "BRIGHTPOINT 56 BAY STREET OUTPATIENT TREATMENT",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103012563",
            "telephone_number": "718-808-1439",
            "fax_number": "718-808-1393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN RIVER HEALTH INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUN RIVER HEALTH INC",
        "enumeration_date": "2018-09-08",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A",
        "authorized_official_last_name": "LIPTON",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "VP INFO/PRACTICE MGMT SYSTEMS",
        "authorized_official_telephone_number": "914-384-2375"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NY",
            "license": "5901200R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "W38731",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00473038",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brightpoint 56 Bay Street Outpatient Treatment",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Brightpoint 56 Bay Street Outpatient Treatment",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.