Organization Active NPI

St. John'S Riverside Hospital-Pathology

  • Anatomic Pathology & Clinical Pathology Physician
  • Yonkers, NY
National Provider Identifier
1295765840
Registry record updated Oct 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
ST. JOHN'S RIVERSIDE HOSPITAL-PATHOLOGY
Practice address
967 N Broadway
Yonkers, NY 10701-1301
Phone
(914) 966-9787
Fax
(914) 966-9793
NPI assigned
Jul 3, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Silvia Ugalde
Title
Assistant Vice President
Phone
(914) 964-9787

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040719001272 NY Part B Supplier - Clinic/Group Practice 5799764031 Receives reassigned benefits from 6 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Yonkers, NY

National Provider Directory

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X Primary

Addresses

NPPES NPI Registry

Primary practice location

967 N Broadway
Yonkers, NY 10701-1301

Mailing address

PO Box 998
Attn: Riverside Management Services Org
Yonkers, NY 10703-0998
Phone (914) 966-9787

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 22, 2007.

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193011200000",
    "number": "1295765840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 998",
            "address_2": "ATTN: RIVERSIDE MANAGEMENT SERVICES ORG",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107030998",
            "telephone_number": "914-966-9787",
            "fax_number": "914-966-9793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "967 N BROADWAY",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107011301",
            "telephone_number": "914-966-9787",
            "fax_number": "914-966-9793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOHN'S RIVERSIDE HOSPITAL-PATHOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2007-10-22",
        "status": "A",
        "authorized_official_last_name": "UGALDE",
        "authorized_official_first_name": "SILVIA",
        "authorized_official_title_or_position": "ASSISTANT VICE PRESIDENT",
        "authorized_official_telephone_number": "914-964-9787"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2007; 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.

Verify at the official NPI Registry.