Healthalliance Hospital Marys Avenue Campus

Primary specialty

Psychiatric Hospital UnitTaxonomy code 273R00000X

Legal business name

HEALTHALLIANCE HOSPITAL MARYS AVENUE CAMPUS

Practice address

105 Marys Ave
Kingston, NY 12401-5848

Phone

(845) 943-6007

Fax

(845) 943-6038

NPI assigned

Mar 8, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Mario Difiglia, FHFMA

Title

Vice President

Phone

(914) 493-7909

Specialties & licenses 1

Addresses

Other identifiers 8

Other names 1

• Benedictine Hospital Former legal business name

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Hospital certification: CCN 33S224

Legal name

HEALTHALLIANCE HOSPITAL MARYS AVENUE CAMPUS

Organization structure

CorporationNon-profit

Enrollment address

105 Marys Ave
Kingston, NY 12401-5829
Hospital Psychiatric Unit

Hospital subgroups

Psychiatric

Related certifications (CCN) 1

Facilities connected through Provider of Services related, parent or unit certification numbers.

• Healthalliance Hospital Marys Avenue Campus

  • General Acute Care Hospital
  • Kingston, NY
  • NPI 1932182599

  Unit of hospital

  Provider of Services

Other NPIs with the same Medicare PAC ID 2

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

• Healthalliance Hospital Marys Avenue Campus

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Kingston, NY
  • NPI 1215989041

  5597665844

  Same PAC ID
• Healthalliance Hospital Marys Avenue Campus

  • General Acute Care Hospital
  • Kingston, NY
  • NPI 1932182599

  5597665844

  Same PAC ID

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Vassar Brothers Hospital Ulster Radiation Oncology Center

  • Radiation Oncology Clinic/Center
  • Kingston, NY
  • NPI 1457426165

  Member Of

  NPD member

Locations

All disclosed owners & managing parties 13

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

Owners & managing parties with NPI records 2

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

• Jamal Mahdavian, MD

  • Surgery Physician
  • Kingston, NY
  • NPI 1144373929

  Corporate Director

  CMS ownership
• Falak B Shah, MD

  • Interventional Cardiology Physician
  • Kingston, NY
  • NPI 1215199237

  Corporate Director

  CMS ownership

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• Healthalliance Hospital Marys Avenue Campus

  • General Acute Care Hospital
  • Kingston, NY
  • NPI 1932182599

  Health Alliance

  CMS ownership
• Margaretville Memorial Hospital

  • Critical Access Hospital
  • Margaretville, NY
  • NPI 1164473039

  Health Alliance

  CMS ownership
• Margaretville Memorial Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Margaretville, NY
  • NPI 1740233840

  Health Alliance

  CMS ownership

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rebecca Ackerman-Raphael, MD

  • Psychiatry Physician
  • Kingston, NY
  • NPI 1912957788
  NPD (past)
• Michael NG, M.D.

  • Neurology Physician
  • Staten Island, NY
  • NPI 1942351267
  NPD (past)
• Christopher Joseph Edward Harper, M.D.

  • Dermatology Physician
  • Pomona, CA
  • NPI 1013150630
  NPD (past)

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743033600000",
    "number": "1285601237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 MARYS AVE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124015829",
            "telephone_number": "845-943-6007",
            "fax_number": "845-943-6038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MARYS AVE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124015848",
            "telephone_number": "845-943-6007",
            "fax_number": "845-943-6038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHALLIANCE HOSPITAL MARYS AVENUE CAMPUS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-08",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A",
        "authorized_official_last_name": "DIFIGLIA",
        "authorized_official_first_name": "MARIO",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "914-493-7909",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "FHFMA"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI PROVIDER ID",
            "identifier": "3185",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROV ID",
            "identifier": "6450795",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NUMBE",
            "identifier": "000702",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00274020",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE PROV ID",
            "identifier": "103185",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS PROV ID",
            "identifier": "143278",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP PROVIDER ID",
            "identifier": "10005742",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP HEALTH PLAN PROV ID",
            "identifier": "UV5282",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Benedictine Hospital",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Benedictine Hospital",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Psychiatric Hospital Unit in Kingston, NY
• Providers in Kingston, NY by specialty
• Psychiatric Hospital Unit in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.