NPIMap

Organization Active NPI

Carefirst Ny, Inc.

Doing business as Southern Tier Hospice and Palliative Care (formerly)

  • Community Based Hospice Care Agency
  • Painted Post, NY
National Provider Identifier
1285638775
Registry record updated Mar 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
0721501F Issued in NY
Legal business name
CAREFIRST NY, INC.
Doing business as
Southern Tier Hospice and Palliative Care (formerly)
Practice address
3805 Meads Creek Rd
Painted Post, NY 14870-9509
Phone
(607) 962-3100
Fax
(607) 962-4300
NPI assigned
Jun 13, 2005
Last updated
Mar 8, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2017

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

Authorized official

Name
Mrs. Stacey L Lee
Title
Chief Financial Officer
Phone
(607) 962-3100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 0721501F NY Primary

Addresses

Primary practice location

3805 Meads Creek Rd
Painted Post, NY 14870-9509

Mailing address

3805 Meads Creek Rd
Painted Post, NY 14870-9509
Phone (607) 962-3100

Other names 1

  • Southern Tier Hospice and Palliative Care (formerly) Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031223000088 NY Part A Provider - Hospice 2264330661 Practice locations: Painted Post, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285638775. Details of each certification follow.

Hospice certification: CCN 331513

Legal name
CAREFIRST NY INC
Doing business as
CAREFIRST
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jun 27, 1986
Last certification
Mar 3, 2020
Ownership / control type
Other
Organization structure
CorporationNon-profit
Incorporated
Feb 23, 1982 in NY
Enrollment address
3805 Meads Creek Rd
Painted Post, NY 14870-9509

Care Compare: Hospice

Medicare Care Compare
Listed as
Carefirst / Southern Tier Hospice and PalliativeCCN 331513 · All quality measures
Ownership
Non-Profit
Certified
Jun 27, 1986
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

11751 E Corning Rd
Corning, NY 14830
Phone (607) 962-3100

3805 Meads Creek Rd
Painted Post, NY 14870
Phone (607) 542-2769

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Craig Casper Individual Corporate DirectorBoard Member Jan 17, 2018
Zachary N Knapp Individual Corporate DirectorBoard Member May 31, 2017
Chelsea E Ambrose Individual Corporate DirectorDirector of Clinical Services Sep 18, 2019
Thomas Writh Individual Corporate DirectorBoard Member May 1, 2013
Joseph Rogers Individual Corporate DirectorBoard Member Aug 31, 2017
John Carozza Individual Corporate DirectorBoard Member May 31, 2015
Carol L Holobinko Individual Corporate DirectorBoard Member May 16, 2018
Bharathi U Thuraisamy Individual Corporate DirectorMedical Director Sep 18, 2019
Karen Hogue Individual Corporate DirectorBoard Member May 1, 2014
Paul Vervalin Individual Corporate DirectorBoard Member May 1, 2015
Jeff Yockavitch Individual Corporate OfficerCeo Sep 18, 2019
Pamela Bliss Individual Corporate DirectorBoard Member May 1, 2011
Michael T Jagielski Individual Corporate DirectorBoard Member May 1, 2016
Noelle J Gross Individual Corporate DirectorDirector of Finance Oct 8, 2019
Operational/Managerial ControlDirector of Finance Oct 8, 2019
Michael Manzari Individual Corporate DirectorBoard Member May 1, 2012

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

Affiliated clinicians 60

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

View all 60

NPI Registry JSON

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488931200000",
    "number": "1285638775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3805 MEADS CREEK RD",
            "city": "PAINTED POST",
            "state": "NY",
            "postal_code": "148709509",
            "telephone_number": "607-962-3100",
            "fax_number": "607-962-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3805 MEADS CREEK RD",
            "city": "PAINTED POST",
            "state": "NY",
            "postal_code": "148709509",
            "telephone_number": "607-962-3100",
            "fax_number": "607-962-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAREFIRST NY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-13",
        "last_updated": "2017-03-08",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "607-962-3100",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NY",
            "license": "0721501F",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Tier Hospice and Palliative Care (formerly)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Painted Post, NY

Sources for this page

Verify at the official NPI Registry.