NPIMap

Organization Active NPI

MVHS Inc

Doing business as Wynn Hospital

  • Rehabilitation Hospital Unit
  • Utica, NY
National Provider Identifier
1184717837
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
License
3202003H Issued in NY
Legal business name
MVHS INC
Doing business as
Wynn Hospital
Practice address
111 Hospital Dr.
Utica, NY 13502
Phone
(315) 917-9966
Fax
(315) 234-3998
NPI assigned
Oct 2, 2006
Last updated
Feb 9, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
MVHS INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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

Authorized official

Name
Cody White
Title
Avp Revenue Cycle Services
Phone
(315) 801-4429

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X 3202003H NY Primary

Addresses

Primary practice location

111 Hospital Dr.
Utica, NY 13502

Mailing address

2215 Genesee St
Utica, NY 13501-5930
Phone (315) 801-4238

Other practice location 1

1650 Champlin Ave
Utica, NY 13502-4801
Phone (315) 624-8600

Other names 1

  • Wynn Hospital Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111103000020 NY Part A Provider - Hospital 2769380252 Practice locations: Utica, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1184717837. Details of each certification follow.

Hospital certification: CCN 33T044

Legal name
MVHS INC
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 2000 in NY
Enrollment address
1676 Sunset Ave
Utica, NY 13502-5416
Other Hospital Practice Location
Hospital subgroups
Rehabilitation unit

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).

  • MVHS Inc

    dba Wynn Hospital

    • General Acute Care Hospital
    • Utica, NY
    • NPI 1205877172

    2769380252

    Same PAC ID
  • MVHS Inc

    dba Mohawk Valley Health System Inc

    • Community/Retail Pharmacy
    • Utica, NY
    • NPI 1306573753

    2769380252

    Same PAC ID
  • MVHS Inc

    dba Mohawk Valley Health System Inc

    • Family Medicine Physician
    • Utica, NY
    • NPI 1770690737

    2769380252

    Same PAC ID

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Faxton-St. Lukes HealthcareCCN 33T044 · All quality measures
Ownership
Non-profit
Certified
Jan 1, 2002

National Provider Directory

National Provider Directory
Tax ID family
Faxton St Lukes Ilion5 organizations share this tax ID, including this one
Part of
Faxton St Lukes Ilion

Other organizations with this tax ID 4

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

  • MVHS Inc

    dba Mohawk Valley Health System Inc

    • Community/Retail Pharmacy
    • Utica, NY
    • NPI 1306573753
    NPD tax ID
  • MVHS Inc

    dba Mohawk Valley Health System Inc

    • Institutional Pharmacy
    • Utica, NY
    • NPI 1619398492
    NPD tax ID
  • MVHS Inc

    dba Mohawk Valley Health System Inc

    • General Acute Care Hospital
    • Utica, NY
    • NPI 1649350380
    NPD tax ID
  • MVHS Inc

    dba Mohawk Valley Health System Inc

    • Health Educator
    • Utica, NY
    • NPI 1972123735
    NPD tax ID

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Mohawk Valley Health System Organization, Utica, NY Corporation Operational/Managerial Control Jan 1, 2007 100%
Barara Falatico Individual Corporate OfficerBoard Member Mar 1, 2014
Kimberly Lorraine Individual W-2 Managing EmployeeSsi System Administrator Sep 7, 2023
Belinda Grossi Individual W-2 Managing EmployeeCredentialing Department Jul 26, 2022
Louis Aiello Individual Corporate Officer Jan 1, 2014
W-2 Managing EmployeeSr. VP, Cfo Mar 1, 2014
Cody White Individual Corporate DirectorDirector of Revenue Cycle Jan 1, 2019
Alicia M Detraglia Individual Corporate Director Jan 1, 2018

Owners & managing parties with NPI records 1

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

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Practitioners 6

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.

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707436800000",
    "number": "1184717837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 GENESEE ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135015930",
            "telephone_number": "315-801-4238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 HOSPITAL DR.",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "13502",
            "telephone_number": "315-917-9966",
            "fax_number": "315-234-3998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1650 Champlin Ave",
            "address_purpose": "LOCATION",
            "city": "Utica",
            "state": "NY",
            "postal_code": "135024801",
            "country_code": "US",
            "telephone_number": "315-624-8600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MVHS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MVHS INC",
        "enumeration_date": "2006-10-02",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "CODY",
        "authorized_official_title_or_position": "AVP REVENUE CYCLE SERVICES",
        "authorized_official_telephone_number": "315-801-4429"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "NY",
            "license": "3202003H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Wynn Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Utica, NY

Sources for this page

Verify at the official NPI Registry.