NPIMap

Organization Active NPI

Geneva General Hospital, Inc

  • Family Medicine Physician
  • Clyde, NY
National Provider Identifier
1255087003
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GENEVA GENERAL HOSPITAL, INC
Practice address
4 W Genesee St
Clyde, NY 14433-1126
Phone
(315) 923-3640
NPI assigned
Mar 1, 2022
Last updated
Mar 1, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
GENEVA GENERAL HOSPITAL, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Authorized official

Name
Trisha Koczent
Title
Cfo & Treasurer
Phone
(315) 787-4030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

4 W Genesee St
Clyde, NY 14433-1126

Mailing address

4 W Genesee St
Clyde, NY 14433-1126
Phone (315) 923-3640

Other identifiers 1

IdentifierTypeStateIssuer
03029229MedicaidNY

Other names 1

  • Clyde Family Health Center Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050420000887 NY Part A Provider - Hospital 7810809407 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Clyde, NY; Geneva, NY; Seneca Falls, NY; Waterloo, NY
O20080728000487 NY Part B Supplier - Hospital Department(S) 7810809407 Receives reassigned benefits from 49 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Geneva, NY; Clyde, NY; Waterloo, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255087003. Details of each certification follow.

Hospital certification: CCN 330058

Legal name
GENEVA GENERAL HOSPITAL, INC
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Feb 4, 2026
Beds
132
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Mar 25, 1892 in NY
Enrollment address
196 North St
Geneva, NY 14456-1651
Hospital subgroups
General, Acute care, Swing-bed approved

Other NPIs on the same Medicare enrollment 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Geneva General HospitalCCN 330058 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Other
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Geneva General HospitalCCN 33T058
Ownership
Non-profit
Certified
Jan 1, 1998

This is a unit of this hospital with its own CMS Certification Number. Care Compare reports it separately, and it has no NPI of its own. How units are connected

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
33D1069833Clyde Family Health Center4 W Genesee Street, Clyde, NY 14433Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory
Part of
Geneva General Hospital Inc

Locations

4 W Genesee St
Clyde, NY 14433
Phone (315) 923-3640

200 North St
Ste 203
Geneva, NY 14456
Phone (315) 787-4204

200 North St
Ste 304
Geneva, NY 14456
Phone (315) 607-8915

35 Mason St
Ste 206
Geneva, NY 14456
Phone (315) 787-5355

821 Pre Emption Rd
Ste 302
Geneva, NY 14456
Phone (315) 787-5333

418 N Main St
Penn Yan, NY 14527
Phone (315) 531-2000

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Kathi S Finizio Individual W-2 Managing EmployeeDirector of Patient Financial SE Sep 3, 2013
Operational/Managerial Control Sep 3, 2013
Robert D Anderson Individual Corporate Director Sep 14, 2021
Craig Densmore Individual Corporate Director Apr 25, 2018
Chevanne Devaney Individual Corporate Director Apr 26, 2017
Jose Acevedo Individual Corporate Director Jun 23, 2010
Rodolfo Queiroz Individual Corporate Director Sep 14, 2021
James Cheney Individual Corporate Director Apr 27, 2016
Ryan Hallings Individual Corporate Director Apr 24, 2019
James Nardozzi Individual Corporate Director Sep 14, 2021
Scott a Mooney Individual Corporate Director Sep 14, 2021
Susan Stork Individual Corporate Director Apr 24, 2019
Kylene Abraham Individual Corporate Director Apr 26, 2017
Thomas Burrall Individual Corporate Director Apr 25, 2018
Trisha Koczent Individual Corporate DirectorTreasurer & Cfo May 24, 2021
W-2 Managing Employee May 24, 2021
Ann H McMullen Individual Corporate Director Sep 14, 2021
Lance Ward Individual Corporate Director Apr 22, 2015
Phillip Beckley Individual Corporate Director Jun 23, 2010
John Hicks Individual Corporate Director Jun 23, 2010

Owners & managing parties with NPI records 4

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

Practitioners & affiliated clinicians

Practitioners 173

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 173

Affiliated clinicians 290

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

View all 290

NPI Registry JSON

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

{
    "created_epoch": "1646092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646092800000",
    "number": "1255087003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 W GENESEE ST",
            "city": "CLYDE",
            "state": "NY",
            "postal_code": "144331126",
            "telephone_number": "315-923-3640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 W GENESEE ST",
            "city": "CLYDE",
            "state": "NY",
            "postal_code": "144331126",
            "telephone_number": "315-923-3640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENEVA GENERAL HOSPITAL, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GENEVA GENERAL HOSPITAL, INC",
        "enumeration_date": "2022-03-01",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A",
        "authorized_official_last_name": "KOCZENT",
        "authorized_official_first_name": "TRISHA",
        "authorized_official_title_or_position": "CFO & TREASURER",
        "authorized_official_telephone_number": "315-787-4030"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03029229",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clyde Family Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Clyde, NY

Sources for this page

Verify at the official NPI Registry.