NPIMap

Organization Active NPI

United Cerebral Palsy Assoc of Nys Inc

  • Clinic/Center
  • Goshen, NY
National Provider Identifier
1205995362
Registry record updated Jan 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
7002126R Issued in NY
Legal business name
UNITED CEREBRAL PALSY ASSOC OF NYS INC
Practice address
2 Fletcher St
Goshen, NY 10924-1402
Phone
(845) 294-7300
Fax
(845) 294-2391
NPI assigned
Dec 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2008

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

Authorized official

Name
Mr. Thomas Mandelkow
Title
Exec VP
Phone
(212) 947-5770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 7002126R NY Primary

Addresses

Primary practice location

2 Fletcher St
Goshen, NY 10924-1402

Mailing address

330 W 34TH St FL 15
New York, NY 10001-2406
Phone (212) 947-5770

Other identifiers 2

IdentifierTypeStateIssuer
00947324MedicaidNY
LOCATOR CODE 10MedicaidNY

Other names 1

  • Inspire The CP Center Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040420000110 NY Part B Supplier - Clinic/Group Practice 0749275584 Receives reassigned benefits from 26 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bronx, NY; Brooklyn, NY; Long Island City, NY; Oakland Gardens, NY; Staten Island, NY

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201737600000",
    "number": "1205995362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 W 34TH ST FL 15",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100012406",
            "telephone_number": "212-947-5770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 FLETCHER ST",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109241402",
            "telephone_number": "845-294-7300",
            "fax_number": "845-294-2391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED CEREBRAL PALSY ASSOC OF NYS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2008-01-31",
        "status": "A",
        "authorized_official_last_name": "MANDELKOW",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "EXEC VP",
        "authorized_official_telephone_number": "212-947-5770",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NY",
            "license": "7002126R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00947324",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LOCATOR CODE 10",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Inspire The CP Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Goshen, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.