NPIMap

Organization Active NPI

St Joseph's Hospital Health Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Camillus, NY
National Provider Identifier
1265462386
Registry record updated Nov 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
ST JOSEPH'S HOSPITAL HEALTH CENTER
Practice address
5101 West Genesee Street
Camillus, NY 13031
Phone
(315) 488-2979
Fax
(315) 488-3499
NPI assigned
Jul 4, 2006
Last updated
Nov 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2008

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

Authorized official

Name
Mr. Michael Shaffer
Title
VP of Fiscal Affairs, Cfo
Phone
(315) 448-5880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X NU Primary

Addresses

Primary practice location

5101 West Genesee Street
Camillus, NY 13031

Mailing address

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5880

Other identifiers 2

IdentifierTypeStateIssuer
02995893MedicaidNY
00315013MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
St Josephs Hosp Cardio4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5101 W Genesee St
Camillus, NY 13031
Phone (315) 488-2979

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225756800000",
    "number": "1265462386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13203",
            "telephone_number": "315-448-5880",
            "fax_number": "315-448-6161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5101 WEST GENESEE STREET",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "13031",
            "telephone_number": "315-488-2979",
            "fax_number": "315-488-3499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOSEPH'S HOSPITAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2008-11-04",
        "status": "A",
        "authorized_official_last_name": "SHAFFER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "VP OF FISCAL AFFAIRS, CFO",
        "authorized_official_telephone_number": "315-448-5880",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02995893",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00315013",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camillus, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.