NPIMap

Organization Active NPI

Urban Resource Institute

  • Intellectual Disabilities Intermediate Care Facility
  • Jamaica, NY
National Provider Identifier
1205048105
Registry record updated Dec 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
7712440 Issued in NY
Legal business name
URBAN RESOURCE INSTITUTE
Practice address
15519 Linden Blvd
Jamaica, NY 11434-1017
Phone
(646) 588-0030
Fax
(646) 588-0033
NPI assigned
May 4, 2007
Last updated
Dec 14, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2016

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

Authorized official

Name
Donovan Murray, CPA
Title
Senior Vice President, Finance/Cfo
Phone
(646) 588-0040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 7712440 NY Primary

Addresses

Primary practice location

15519 Linden Blvd
Jamaica, NY 11434-1017

Mailing address

75 Broad St
Suite 505
New York, NY 10004-2415
Phone (646) 588-0030

Other identifiers 1

IdentifierTypeStateIssuer
01207661MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Urban Resource Institute5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

75 Broad St
Rm 505
New York, NY 10004

Practitioners & affiliated clinicians

Practitioners 1

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": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481673600000",
    "number": "1205048105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 BROAD ST",
            "address_2": "SUITE 505",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100042415",
            "telephone_number": "646-588-0030",
            "fax_number": "646-588-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15519 LINDEN BLVD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114341017",
            "telephone_number": "646-588-0030",
            "fax_number": "646-588-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "URBAN RESOURCE INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2016-12-14",
        "status": "A",
        "authorized_official_last_name": "MURRAY",
        "authorized_official_first_name": "DONOVAN",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT, FINANCE/CFO",
        "authorized_official_telephone_number": "646-588-0040",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "NY",
            "license": "7712440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01207661",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2016; 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.