NPIMap

Organization Active NPI

Good Samaritan Hospital Medical Center

Doing business as Good Samaritan Nursing Home

  • Skilled Nursing Facility
  • Sayville, NY
National Provider Identifier
1275529612
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
5154310N Issued in NY
Legal business name
GOOD SAMARITAN HOSPITAL MEDICAL CENTER
Doing business as
Good Samaritan Nursing Home
Good Samaritan Nursing and Rehabilitation Care Center
Practice address
101 Elm St
Sayville, NY 11782-3111
Phone
(631) 244-2400
Fax
(631) 244-2405
NPI assigned
Sep 21, 2005
Last updated
Apr 22, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
GOOD SAMARITAN HOSPITAL MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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

Authorized official

Name
Justin Lundbye
Title
President
Phone
(631) 376-4186

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 5154310N NY Primary

Addresses

Primary practice location

101 Elm St
Sayville, NY 11782-3111

Mailing address

101 Elm St
Sayville, NY 11782-3111
Phone (631) 862-3951

Other identifiers 1

IdentifierTypeStateIssuer
00439905MedicaidNY

Other names 2

  • Good Samaritan Nursing Home Doing business as
  • Good Samaritan Nursing and Rehabilitation Care Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111129000526 NY Part A Provider - Skilled Nursing Facility 5294639951 Practice locations: Sayville, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1275529612. Details of each certification follow.

Skilled nursing facility certification: CCN 335636

Legal name
GOOD SAMARITAN HOSPITAL MEDICAL CENTER
Doing business as
GOOD SAMARITAN NURSING HOME
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 17, 1980
Last certification
Mar 19, 2025
Beds
100
Ownership / control type
Church Related
Organization structure
CorporationNon-profit
Incorporated
Mar 7, 1961 in NY
Enrollment address
101 Elm St
Sayville, NY 11782-3193
Nursing home name
GOOD SAMARITAN NURSING AND REHABILITATION CARE CTR

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Good Samaritan Nursing and Rehabilitation Care CtrCCN 335636 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Church related
Certified
Jan 17, 1980
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10076.9 residents per day on average

Processed by Care Compare on Aug 1, 2026.

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
33D0703394Good Samaritan Nursing Home101 Elm Street, Sayville, NY 11782Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory
Tax ID family
Good Samaritan Wi-Oxyge11 organizations share this tax ID, including this one
Part of
Good Samaritan Wi-Oxyge

Other organizations with this tax ID 10

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

Ownership & related parties

All disclosed owners & managing parties 25

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

NameRoleSinceShare
Frank Misiano Individual W-2 Managing EmployeeChief Administrative Officer Jan 1, 2017 100%
Anthony F Marano Individual Corporate Director Jan 1, 2017
Stephen F McLouglin Individual Corporate Director Jan 1, 2017
Alan Guerci Individual Corporate OfficerPresident and Ceo Jan 1, 2017 100%
Jerome M Poller Individual Corporate DirectorVice Chair, Board of Trustees Jan 1, 2011
Robert O Morrissey Individual Corporate Director Jan 1, 2017
John Wagner Individual Corporate Director Jan 1, 2017
Christopher S Pascucci Individual Corporate Director Jan 1, 2017
Brian R McGuire Individual Corporate Director Jan 1, 2017
Thomas E Christman Individual Corporate Director Jan 1, 2017
Peter P D'Angelo Individual Corporate Director Jan 1, 2017
William Ward Individual Corporate Director Jan 1, 2017
Virginia a Ewen Individual Corporate Director Jan 1, 2017
John Haight Individual Corporate OfficerDirector of Finance Sep 1, 2011
Frank L Kurre Individual Corporate Director Jan 1, 2017
Salvatore F Sodano Individual Corporate DirectorChair, Board of Trustees Jan 1, 2011
Alexander Hazelton Individual Corporate Director Jan 1, 2017
Peter J Dugandzic Individual Corporate Director Jan 1, 2017
James C Vlaun Individual Corporate Director Jan 1, 2017
John W Francfort Individual Corporate Director Jan 1, 2017
Robert Zuccaro Individual Corporate Director Jan 1, 2017
Peter Quick Individual Corporate Director Jan 1, 2017
Barbara Ellen Black Individual Corporate Director Jan 1, 2017
Daniel T Rowe Individual Corporate Director Jan 1, 2017
Kevin J Conway Individual Corporate Director Jan 1, 2017

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 1

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.

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776816000000",
    "number": "1275529612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 ELM ST",
            "city": "SAYVILLE",
            "state": "NY",
            "postal_code": "117823111",
            "telephone_number": "631-862-3951",
            "fax_number": "631-862-3906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 ELM ST",
            "city": "SAYVILLE",
            "state": "NY",
            "postal_code": "117823111",
            "telephone_number": "631-244-2400",
            "fax_number": "631-244-2405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SAMARITAN HOSPITAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GOOD SAMARITAN HOSPITAL MEDICAL CENTER",
        "enumeration_date": "2005-09-21",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A",
        "authorized_official_last_name": "LUNDBYE",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-376-4186"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "5154310N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00439905",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Samaritan Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Good Samaritan Nursing and Rehabilitation Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sayville, NY

Sources for this page

Verify at the official NPI Registry.