Active NPI
Good Samaritan Lutheran Health Care Center
- Skilled Nursing Facility
- Delmar, NY
National Provider Identifier
1265422166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 141777540
- Legal business name
- GOOD SAMARITAN LUTHERAN HEALTH CARE CENTER
- Practice address
- 125 Rockefeller Rd
Delmar, NY 12054-2221 - Phone
- (518) 439-8116
- NPI assigned
- Oct 24, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Rafi Lehmann
- Title
- Administrator
- Phone
- (518) 439-8116
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 141777540 | NY | Primary |
Addresses
Primary practice location
125 Rockefeller Rd
Delmar, NY 12054-2221
Mailing address
4770 White Plains Rd
Bronx, NY 10470-1104
Phone (718) 931-9700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00308567 | Medicaid | NY |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130112000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1604966400000",
"number": "1265422166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4770 WHITE PLAINS RD",
"city": "BRONX",
"state": "NY",
"postal_code": "104701104",
"telephone_number": "718-931-9700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 ROCKEFELLER RD",
"city": "DELMAR",
"state": "NY",
"postal_code": "120542221",
"telephone_number": "518-439-8116"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GOOD SAMARITAN LUTHERAN HEALTH CARE CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2005-10-24",
"last_updated": "2020-11-10",
"certification_date": "2020-11-10",
"status": "A",
"authorized_official_last_name": "LEHMANN",
"authorized_official_first_name": "RAFI",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "518-439-8116"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NY",
"license": "141777540",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00308567",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Delmar, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.