NPIMap

Organization Active NPI

Nys Office of Mental Health

  • Adult Mental Health Clinic/Center
  • Queens Village, NY
National Provider Identifier
1194889097
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
NYS OFFICE OF MENTAL HEALTH
Practice address
7925 Winchester Blvd
Queens Village, NY 11427-2128
Phone
(718) 464-7500
NPI assigned
Dec 22, 2006
Last updated
Mar 18, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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

Authorized official

Name
Shweta Gupta
Title
Director, Finance
Phone
(518) 473-3598

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NY Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X NY
Specialty Pharmacy 3336S0011X NY

Addresses

Primary practice location

7925 Winchester Blvd
Queens Village, NY 11427-2128

Mailing address

44 Holland Ave
Albany, NY 12229-0001
Phone (518) 473-3598

Other identifiers 2

IdentifierTypeStateIssuer
00769411MedicaidNY
02711475MedicaidNY

Other names 1

  • Creedmoor Psychiatric Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110802000194 NY Part B Supplier - Clinic/Group Practice 3072782432 Receives reassigned benefits from 54 practitioners
20 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Staten Island, NY; West Brentwood, NY; Utica, NY; Syracuse, NY; Rochester, NY; Queens Village, NY; Poughkeepsie, NY; Orangeburg, NY…
O20160108001621 NY Part A Provider - Hospital 3072782432 1 other NPI on this enrollment
Practice locations: Queens Village, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194889097. Details of each certification follow.

Hospital certification: CCN 334004

Legal name
NYS OFFICE OF MENTAL HEALTH
Doing business as
CREEDMOOR PSYCHIATRIC CENTER
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Jul 1, 1966
Last certification
Nov 8, 2025
Beds
476
Ownership / control type
State
Organization structure
GovernmentNon-profit
Enrollment address
79-25 Winchester Boulevard
Queens Village, NY 11427-2199
Hospital subgroups
Psychiatric, Other

Other NPIs with the same Medicare PAC ID 22

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

View all 22

Other NPIs on the same Medicare enrollment 21

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

View all 21

Care Compare: Hospital

Medicare Care Compare
Listed as
Creedmoor Psychiatric CenterCCN 334004 · All quality measures
Type
Psychiatric
Ownership
Government - State
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2029184Creedmoor Psychiatric Center79-25 Winchester Blvd, Queens Village, NY 11427Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory
Tax ID family
Buffalo PC147 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Nys Office of Mental Health Organization, Albany, NY Operational/Managerial Control Feb 24, 2023
Beth Giarrusso Individual Corporate DirectorDirector State Operations Financ Apr 23, 2015 5%
W-2 Managing EmployeeDirector State Operations Financ Apr 23, 2015 5%
Mark S Brooks Individual W-2 Managing EmployeeAsst Dir Costing Rate Rev MGMT Apr 1, 2015 5%

Owners & managing parties with NPI records 22

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

View all 22

All facility ownership & control disclosures 18

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

FacilityTypeRoleSince
Rockland Psychiatric CenterOrangeburg, NY, CCN 334015 Hospital Operational/Managerial Control Nov 26, 2019
South Beach Psychiatric CenterStaten Island, NY, CCN 334043 Hospital Operational/Managerial Control Nov 26, 2019
Mohawk Valley Psychiatric CenterUtica, NY, CCN 334021 Hospital Operational/Managerial Control Jan 2, 2020
Mid Hidson Psychiatric CenterNew Hampton, NY, CCN 334061 Hospital Operational/Managerial Control Feb 10, 2020
Kingsboro Psychiatric CenterBrooklyn, NY, CCN 334063 Hospital Operational/Managerial Control Mar 7, 2022
Elmira Psychiatric CenterElmira, NY, CCN 334045 Hospital Operational/Managerial Control Mar 3, 2022
Manhattan Psychiatric CenterNew York, NY, CCN 334054 Hospital Operational/Managerial Control Sep 30, 2010
Bronx Psychiatric CenterBronx,, NY, CCN 334053 Hospital Operational/Managerial Control Mar 7, 2022
Kirby Forensic Psychiatric CenterNew York, NY, CCN 334060 Hospital Operational/Managerial Control Mar 7, 2022
Rochester Psychiatric CenterRochester, NY, CCN 334020 Hospital Operational/Managerial Control Mar 2, 2022
Hutchings Psychiatric CenterSyracuse, NY, CCN 334001 Hospital Operational/Managerial Control Feb 16, 2022
Capital District Psychiatric CenterAlbany, NY, CCN 334046 Hospital Operational/Managerial Control Mar 4, 2022
St. Lawrence Psychiatric CenterOgdensburg, NY, CCN 334003 Hospital Operational/Managerial Control Mar 1, 2022
New York State Psychiatric InstituteNew York, NY, CCN 334009 Hospital Operational/Managerial Control Mar 2, 2022
Pilgrim Psychiatric CenterWest Brentwood, NY, CCN 334013 Hospital Operational/Managerial Control Sep 6, 2022
Buffalo Psychiatric CenterBuffalo, NY, CCN 334052 Hospital Operational/Managerial Control Nov 29, 2010
Binghamton Psychiatric CenterBinghamton, NY, CCN 334012 Hospital Operational/Managerial Control Feb 24, 2023
New York City Childrens Psych CenterBellerose, NY, CCN 334067 Hospital Operational/Managerial Control (5%) Oct 27, 2016

Owned or controlled facilities with NPI records 37

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

View all 37

Facilities with the same owner 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773792000000",
    "number": "1194889097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 HOLLAND AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122290001",
            "telephone_number": "518-473-3598",
            "fax_number": "518-473-5167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7925 WINCHESTER BLVD",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114272128",
            "telephone_number": "718-464-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NYS OFFICE OF MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-22",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "SHWETA",
        "authorized_official_title_or_position": "DIRECTOR, FINANCE",
        "authorized_official_telephone_number": "518-473-3598"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NY",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NY",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00769411",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02711475",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Creedmoor Psychiatric Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Queens Village, NY

Sources for this page

Verify at the official NPI Registry.