Active NPI
Julia Dyckman Andrus Memorial, Inc.
- Community/Behavioral Health Agency
- White Plains, NY
National Provider Identifier
1285628552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- License
- 7257001A
- Legal business name
- JULIA DYCKMAN ANDRUS MEMORIAL, INC.
- Practice address
- 19 Greenridge Ave
White Plains, NY 10605-1201 - Phone
- (914) 949-7680
- Fax
- (914) 997-7942
- NPI assigned
- Sep 1, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Raul T Del Pilar
- Title
- Interim Ceo
- Phone
- (914) 965-3700
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | 7257001A | NY | Primary |
Addresses
Primary practice location
19 Greenridge Ave
White Plains, NY 10605-1201
Mailing address
1156 N Broadway
Yonkers, NY 10701-1108
Phone (914) 965-3700
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00355940 | Medicaid | NY | |
| 10363 | Other | HUDSON HEALTH PLAN ID | |
| 050309000005 | Other | NY | INTEGRA FIDELIS |
| 322149 | Other | AFFINITY ID | |
| 3191813 | Other | NY | GHI |
Other names 1
- Andrus Childrens Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050711000916 | NY | Part B Supplier - Clinic/Group Practice | 8426084401 |
Receives reassigned benefits from 19 practitioners Practice locations: Peekskill, NY; White Plains, NY; Yonkers, NY |
National Provider Directory
National Provider Directory- Tax ID family
- Julia Dyckman Andrus Memorial
Other organizations with this tax ID 4
Organizations that report the same tax identification number in the National Provider Directory.
-
- Nursing Care Agency
- Suffern, NY
- NPI 1003350562
-
- Early Intervention Provider Agency
- Yonkers, NY
- NPI 1477912848
-
- Clinical Social Worker
- Yonkers, NY
- NPI 1528443074
-
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Yonkers, NY
- NPI 1003991019
Locations
50 Dayton Ln
Peekskill, NY 10566
Phone (914) 736-3371
19 Greenridge Ave
White Plains, NY 10605
Phone (914) 949-7680
35 Dock St
Yonkers, NY 10701
Phone (914) 965-1109
Practitioners & affiliated clinicians
Practitioners 149
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatric/Mental Health Nurse Practitioner
- White Plains, NY
- NPI 1770614745
NY
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125532800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1599609600000",
"number": "1285628552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1156 N BROADWAY",
"city": "YONKERS",
"state": "NY",
"postal_code": "107011108",
"telephone_number": "914-965-3700",
"fax_number": "914-965-3883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 GREENRIDGE AVE",
"city": "WHITE PLAINS",
"state": "NY",
"postal_code": "106051201",
"telephone_number": "914-949-7680",
"fax_number": "914-997-7942"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JULIA DYCKMAN ANDRUS MEMORIAL, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2005-09-01",
"last_updated": "2020-09-09",
"certification_date": "2020-09-09",
"status": "A",
"authorized_official_last_name": "DEL PILAR",
"authorized_official_first_name": "RAUL",
"authorized_official_middle_name": "T",
"authorized_official_title_or_position": "INTERIM CEO",
"authorized_official_telephone_number": "914-965-3700",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "NY",
"license": "7257001A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00355940",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUDSON HEALTH PLAN ID",
"identifier": "10363",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INTEGRA FIDELIS",
"identifier": "050309000005",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AFFINITY ID",
"identifier": "322149",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "3191813",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Andrus Childrens Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Andrus Childrens Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in White Plains, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.