Capital Region Geriatric Center, Inc.

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

0102001N Issued in NY

Legal business name

CAPITAL REGION GERIATRIC CENTER, INC.

Doing business as

Eddy Cohoes Rehabilitation Center

Practice address

421 West Columbia Street
Cohoes, NY 12047-2217

Phone

(518) 237-5630

Fax

(518) 237-0904

NPI assigned

May 27, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Juanita Wheeler

Title

Director of Finance

Phone

(518) 238-4045

Specialties & licenses 2

Addresses

Other identifiers 7

Other names 1

• Eddy Cohoes Rehabilitation Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1245287168. Details of each certification follow.

• CCN 330407 Hospital · Terminated · Name & address match · Details
• CCN 333029 Hospital · Terminated · Name & address match · Details

Hospital certification: CCN 330407

Legal name

EDDY COHOES REHABILITATION CENTER

Certification status

Terminated Voluntary: merger or closure, Dec 31, 2008

Provider type (POS)

Hospital – Short-term

Participating since

Dec 15, 2006

Last certification

May 24, 2006

Beds

26

Ownership / control type

Private (not for profit)

Facility address

421 West Columbia Street
Cohoes, NY 12047

Hospital certification: CCN 333029

Legal name

EDDY COHOES REHABILITATION CENTER

Certification status

Terminated Other: provider status change, Dec 31, 2006

Provider type (POS)

Hospital – Rehabilitation

Participating since

Feb 1, 1989

Last certification

May 24, 2006

Beds

37

Ownership / control type

Private (not for profit)

Facility address

421 West Columbia Street
Cohoes, NY 12047

Other NPIs on the same Medicare enrollment 1

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

• Capital Region Geriatric Center, Inc.

  dba Eddy Cohoes Rehabilitation Center

  • Skilled Nursing Facility
  • Cohoes, NY
  • NPI 1306885066

  O20040928000884

  Same enrollment

Practitioners 5

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.

• Guerman Ermolenko, MD

  • Geriatric Psychiatry Physician
  • Guilderland, NY
  • NPI 1003828039
  NPD
• Lauren Nicole Fina, FNP-BC

  • Family Nurse Practitioner
  • Albany, NY
  • NPI 1346793585
  NPD (past)
• David Lawrence Herman, M.D.

  • Internal Medicine Physician
  • Cohoes, NY
  • NPI 1073505723
  NPD (past)
• Lynne Longtin, NP

  • Adult Health Nurse Practitioner
  • Troy, NY
  • NPI 1841516432
  NPD (past)
• Maureen Claire Reals, ANP

  • Adult Health Nurse Practitioner
  • Albany, NY
  • NPI 1710669924
  NPD (past)

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245287168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 WEST COLUMBIA STREET",
            "city": "COHOES",
            "state": "NY",
            "postal_code": "120472217",
            "telephone_number": "518-237-5630",
            "fax_number": "518-237-0904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 WEST COLUMBIA STREET",
            "city": "COHOES",
            "state": "NY",
            "postal_code": "120472217",
            "telephone_number": "518-237-5630",
            "fax_number": "518-237-0904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL REGION GERIATRIC CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WHEELER",
        "authorized_official_first_name": "JUANITA",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "518-238-4045",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NY",
            "license": "0102001N",
            "primary": true
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NY",
            "license": "0102001H",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01112234",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "002990",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "102471",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF NE NY",
            "identifier": "000400101001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5613296",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOHAWK VALLEY PHYSICIANS",
            "identifier": "92078",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10005796",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eddy Cohoes Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Peter Burkart, M.D.
• Deanne Marie Busch, LCSW
• Calkins Pharmacy, LLC
• Calkins Residential Services, LLC
• Capital Imaging Associates
• Capital Region Geriatric Center, Inc. (Eddy Cohoes Rehabilitation Center)
• Marni A Carpenter, M.S. OTR/L
• Jillian Carter, RN, IBCLC
• Solomon Chang, PHARM D
• Thomas Chattathil, M.D

• General Acute Care Hospital in Cohoes, NY
• Providers in Cohoes, NY by specialty
• General Acute Care Hospital in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.