NPIMap

Organization Active NPI

Crouse Health Inc.

Doing business as Commonwealth Place

  • Substance Abuse Rehabilitation Facility
  • Syracuse, NY
National Provider Identifier
1265459945
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
04105361 Issued in NY
Legal business name
CROUSE HEALTH INC.
Doing business as
Commonwealth Place
Practice address
6010 E Molloy Rd
Syracuse, NY 13211-2131
Phone
(315) 470-2470
NPI assigned
Jul 17, 2006
Last updated
Jun 18, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
CROUSE HEALTH HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Authorized official

Name
Mrs. Kimberly Boynton
Title
Cfo
Phone
(315) 470-7376

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 04105361 NY Primary

Addresses

Primary practice location

6010 E Molloy Rd
Syracuse, NY 13211-2131

Mailing address

736 Irving Ave
Syracuse, NY 13210-1687
Phone (315) 470-2470

Other identifiers 1

IdentifierTypeStateIssuer
01158709MedicaidNY

Other names 1

  • Commonwealth Place Doing business as

National Provider Directory

National Provider Directory
Part of
Crouse Prompt Care

Locations

2 Broad St
Hamilton, NY 13346
Phone (315) 796-2906

301 Genesee St
Oneida, NY 13421
Phone (315) 361-4610

739 Irving Ave
Syracuse, NY 13210
Phone (315) 470-2951

739 Irving Ave
Ste 100
Syracuse, NY 13210
Phone (315) 470-2971

739 Irving Ave
Ste 340
Syracuse, NY 13210
Phone (315) 470-7747

Practitioners & affiliated clinicians

Practitioners 50

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 50

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1265459945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 IRVING AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101687",
            "telephone_number": "315-470-2470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6010 E MOLLOY RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132112131",
            "telephone_number": "315-470-2470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROUSE HEALTH INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CROUSE HEALTH HOSPITAL",
        "enumeration_date": "2006-07-17",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "BOYNTON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "315-470-7376",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NY",
            "license": "04105361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01158709",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Commonwealth Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.