NPIMap

Organization Active NPI

Good Samaritan Hospital of Suffern

  • General Acute Care Hospital
  • Suffern, NY
National Provider Identifier
1346213469
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
GOOD SAMARITAN HOSPITAL OF SUFFERN
Practice address
255 Lafayette Ave
Suffern, NY 10901-4846
Phone
(845) 368-5000
Fax
(845) 368-5430
NPI assigned
Feb 9, 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
Title
Vice President
Phone
(914) 493-7909

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X NU
General Acute Care Hospital 282N00000X NU Primary

Addresses

Primary practice location

255 Lafayette Ave
Suffern, NY 10901-4846

Mailing address

255 Lafayette Ave
Suffern, NY 10901-4846
Phone (845) 368-5000

Other identifiers 14

IdentifierTypeStateIssuer
1007297990002MedicaidPA
000153OtherNYBLUE CROSS
1007297990003MedicaidPA
4155408MedicaidNJ
0009822OtherNYUS HEALTHCARE
040401000867OtherNYFIDELIS
337015OtherNYMVP
4579OtherNYWELLCARE
00273941MedicaidNY
913OtherNYANTHEM
ID0062OtherNYHEALTHNET
000000004579OtherNYGHI/HMO
H03129OtherNYOXFORD
ID0063OtherNYPHS SMART CHOICE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070413000045 NY Part A Provider - Hospital 4981686367 Practice locations: Pomona, NY; Port Jervis, NY; Suffern, NY; Warwick, NY; West Nyack, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1346213469. Details of each certification follow.

Hospital certification: CCN 330158

Legal name
GOOD SAMARITAN HOSPITAL OF SUFFERN
Doing business as
WMC HEALTH NETWORK - ROCKLAND, INC.
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Apr 25, 2024
Beds
269
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Jan 26, 1904 in NY
Enrollment address
255 Lafayette Ave
Suffern, NY 10901-4812
Main/Primary Hospital Location
Hospital subgroups
Acute care

Care Compare: Hospital

Medicare Care Compare
Listed as
Good Samaritan Hospital of SuffernCCN 330158 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Good Sam Hos Suf-Pul Sys2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

20 Grand St
Warwick, NY 10990
Phone (845) 987-5650

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Anthony E Costello Individual Corporate DirectorVice Chair Jan 1, 2025
Michael N. Rosenblut Individual Corporate DirectorBoard of Director Jan 1, 2021
Andrew Pickens Individual Corporate OfficerExecutive Director Western Region Jun 26, 2025
Corporate DirectorExecutive Director Western Region Jun 26, 2025
W-2 Managing EmployeeExecutive Director Western Region Jun 26, 2025
Bon Secours Charity Health System, Inc. Organization, Suffern, NY Created for acquisition, Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2000 100%
Marie Yezzo Individual Corporate OfficerSVP, Chief Operating Officer Jan 1, 2025
W-2 Managing EmployeeSVP, Chief Operating Officer Jan 1, 2025
Mario Difiglia Individual Corporate DirectorVice President Mar 1, 2024
Susan Gevertz Individual Corporate DirectorBoard of Director Jan 1, 2021
David Lubarsky Individual Corporate DirectorVice Chair Feb 17, 2025
Patrick Baker Individual Corporate DirectorAssistant Vice President Jan 1, 2023
Sandra Grannum Individual Other Jan 1, 2014
Joshua Ratner Individual Corporate DirectorBoard of Directors Jan 1, 2021
Martin Rogowsky Individual Corporate DirectorVice Chair Feb 5, 2025
Tamer El-Rayess Individual Corporate Director1St Vice Chair & Treasurer-B of Dir Jan 1, 2014
Westchester Medical Center Health Network Organization, Valhalla, NY For-profit, Non-profit 5% Or Greater Indirect Ownership Interest Sep 12, 2025 100%

Owners & managing parties with NPI records 1

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

Facilities with the same owner 5

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

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 168

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 168

Affiliated clinicians 540

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

View all 540

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743033600000",
    "number": "1346213469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 LAFAYETTE AVE",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109014846",
            "telephone_number": "845-368-5000",
            "fax_number": "845-368-5430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 LAFAYETTE AVE",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109014846",
            "telephone_number": "845-368-5000",
            "fax_number": "845-368-5430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SAMARITAN HOSPITAL OF SUFFERN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-09",
        "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."
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007297990002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000153",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007297990003",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4155408",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US HEALTHCARE",
            "identifier": "0009822",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "040401000867",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "337015",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "4579",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00273941",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "913",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "ID0062",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI/HMO",
            "identifier": "000000004579",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "H03129",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHS SMART CHOICE",
            "identifier": "ID0063",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffern, NY

Sources for this page

Verify at the official NPI Registry.