NPIMap

Organization Active NPI

Southside Hospital

  • Rehabilitation Hospital Unit
  • Bay Shore, NY
National Provider Identifier
1275541104
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
License
5154000H Issued in NY
Legal business name
SOUTHSIDE HOSPITAL
Practice address
301 E Main St
Bay Shore, NY 11706-8408
Phone
(516) 876-6065
Fax
(516) 876-5572
NPI assigned
Aug 4, 2006
Last updated
Aug 7, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Authorized official

Name
Mrs. Michele Lee Cusack
Title
Senior Vice President & Cfo
Phone
(516) 321-6058

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X 5154000H NY Primary

Addresses

Primary practice location

301 E Main St
Bay Shore, NY 11706-8408

Mailing address

972 Brush Hollow Rd FL 5
Westbury, NY 11590-1740
Phone (516) 876-6065

Other names 1

  • Rehabilitation Unit Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://172.254.9.13:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754524800000",
    "number": "1275541104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "972 BRUSH HOLLOW RD FL 5",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115901740",
            "telephone_number": "516-876-6065",
            "fax_number": "516-876-5572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068408",
            "telephone_number": "516-876-6065",
            "fax_number": "516-876-5572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A",
        "authorized_official_last_name": "CUSACK",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT & CFO",
        "authorized_official_telephone_number": "516-321-6058",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "NY",
            "license": "5154000H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://172.254.9.13:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.1",
            "affiliationName": "Bluemark",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "40 Sunset Ridge Rd",
            "city": "New Paltz",
            "state": "NY",
            "country_code": "US",
            "postal_code": "125611036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Rehabilitation Unit",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Rehabilitation Unit",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2025; 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.