NPIMap

Organization Active NPI

Healthalliance Hospital Marys Avenue Campus

  • Psychiatric Hospital Unit
  • Kingston, NY
National Provider Identifier
1285601237
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
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
Last updated
Mar 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X Primary

Addresses

Primary practice location

105 Marys Ave
Kingston, NY 12401-5848

Mailing address

105 Marys Ave
Kingston, NY 12401-5829
Phone (845) 943-6007

Other names 1

  • Benedictine Hospital Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241126001511 NY Part A Provider - Hospital 5597665844 Practice locations: Kingston, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285601237. Details of each certification follow.

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

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

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory

Member organizations 1

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

Locations

10 Barbarossa Ln
Kingston, NY 12401
Phone (845) 334-2729

25 Field Ct
Kingston, NY 12401
Phone (845) 338-1844

Ownership & related parties

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.

NameRoleSinceShare
Jamal Mahdavian Individual Corporate DirectorBoard Member Oct 20, 2019
Elissa Chessari Individual Corporate OfficerSVP, Chief Operating Officer Nov 8, 2024
W-2 Managing EmployeeSVP, Chief Operating Officer Nov 8, 2024
Anthony E Costello Individual Corporate DirectorBoard Member Jan 1, 2023
Thomas Collins Individual Corporate DirectorBoard Member Jan 1, 2023
Mario Difiglia Individual Corporate DirectorVice President Mar 1, 2024
David Lubarsky Individual Corporate OfficerPresident & Ceo Feb 17, 2025
Corporate DirectorBoard Member Feb 17, 2025
Patrick Baker Individual Corporate DirectorRegional Avp Revenue Cycle Oct 20, 2019
Vishal Desai Individual Corporate DirectorSenior Vice President Mar 1, 2024
Joshua Ratner Individual Corporate DirectorBoard Member Oct 20, 2019
Falak B Shah Individual Corporate DirectorBoard Member Jan 1, 2023
William Frishman Individual Corporate DirectorBoard Member Jan 1, 2023
Craig Sickler Individual Corporate DirectorChair Mar 11, 2009
Health Alliance Organization, Kingston, NY Corporation 5% Or Greater Direct Ownership Interest Mar 1, 2006 100%

Owners & managing parties with NPI records 2

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

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Practitioners 3

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": "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": [],
    "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"
        }
    ]
}

Other providers in Kingston, NY

Sources for this page

Verify at the official NPI Registry.