NPIMap

Organization Active NPI

Tompkins County

  • State or Local Public Health Clinic/Center
  • Ithaca, NY
National Provider Identifier
1306995642
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X
Legal business name
TOMPKINS COUNTY
Practice address
55 Brown Rd
Ithaca, NY 14850-1247
Phone
(607) 274-6616
Fax
(607) 274-6620
NPI assigned
Jan 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Authorized official

Name
Mrs. Brenda L Grinnell-Crosby
Title
Public Health Administrator
Phone
(607) 274-6677

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
State or Local Public Health Clinic/Center 261QP0905X NY Primary

Addresses

Primary practice location

55 Brown Rd
Ithaca, NY 14850-1247

Mailing address

55 Brown Rd
Ithaca, NY 14850-1247
Phone (607) 274-6616

Other identifiers 3

IdentifierTypeStateIssuer
00356258MedicaidNY
000900819000OtherHEALTH NOW
7744090OtherAETNA

Other names 1

  • Tompkins County Health Department Clinic Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101004001295 NY Part B Supplier - Clinic/Group Practice 0143210443 Receives reassigned benefits from 1 practitioner
Practice locations: Ithaca, NY

Other NPIs with the same Medicare PAC ID 1

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

  • Tompkins County
    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Ithaca, NY
    • NPI 1588686596

    0143210443

    Same PAC ID

National Provider Directory

National Provider Directory
Tax ID family
Tompkins County Health6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742515200000",
    "number": "1306995642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 BROWN RD",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501247",
            "telephone_number": "607-274-6616",
            "fax_number": "607-274-6620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 BROWN RD",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501247",
            "telephone_number": "607-274-6616",
            "fax_number": "607-274-6620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOMPKINS COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A",
        "authorized_official_last_name": "GRINNELL-CROSBY",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PUBLIC HEALTH ADMINISTRATOR",
        "authorized_official_telephone_number": "607-274-6677",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00356258",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NOW",
            "identifier": "000900819000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7744090",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tompkins County Health Department Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2025; 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.