NPIMap

Organization Active NPI

MVHS Inc

Doing business as Wynn Hospital

  • General Acute Care Hospital
  • Utica, NY
National Provider Identifier
1205877172
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
3202003H Issued in NY
Legal business name
MVHS INC
Doing business as
Wynn Hospital
Practice address
111 Hospital Dr
Utica, NY 13502-2517
Phone
(315) 917-9966
Fax
(315) 234-3998
NPI assigned
Jun 9, 2006
Last updated
Jan 7, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing and Speech Clinic/Center 261QH0700X
General Acute Care Hospital 282N00000X 3202003H NY Primary

Addresses

Primary practice location

111 Hospital Dr
Utica, NY 13502-2517

Mailing address

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

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
O20040714000986 NY Part A Provider - Hospital 2769380252

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1205877172. Details of each certification follow.

Hospital certification: CCN 330044

Legal name
MVHS INC
Doing business as
WYNN HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Apr 23, 2013
Beds
372
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
111 Hospital Drive
Utica, NY 13502-2517
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

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

    • Rehabilitation Hospital Unit
    • Utica, NY
    • NPI 1184717837

    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: Hospital

Medicare Care Compare
Listed as
Wynn HospitalCCN 330044 · All quality measures
Overall star rating
1 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Marissa Burnup Individual W-2 Managing EmployeeCredentialing Specialist Sep 7, 2023
Mohawk Valley Health System Organization, New Hartford, NY Operational/Managerial Control Mar 1, 2014
Andrea Klumbach Individual W-2 Managing EmployeeCredentialing Specialist Sep 7, 2023
Kimberly Lorraine Individual W-2 Managing EmployeeSsi System Administrator Sep 7, 2023
Belinda Grossi Individual Corporate DirectorCredentialing Department Jul 26, 2022
W-2 Managing Employee Jul 26, 2022
Louis Aiello Individual Corporate Officer Mar 1, 2014
W-2 Managing Employee Mar 1, 2014
Sushma Kaul Individual Corporate DirectorMD Apr 1, 2021
Cody White Individual Corporate DirectorDirector of Revenue Cycle Jan 1, 2019

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 102

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.

View all 102

Affiliated clinicians 843

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

View all 843

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736208000000",
    "number": "1205877172",
    "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": "135022517",
            "telephone_number": "315-917-9966",
            "fax_number": "315-234-3998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MVHS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "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": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "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.