NPIMap

Organization Active NPI

United Cerebral Palsy Association of Greater Suffolk, Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Stony Brook, NY
National Provider Identifier
1346393188
Registry record updated Jul 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
UNITED CEREBRAL PALSY ASSOCIATION OF GREATER SUFFOLK, INC
Practice address
4 Media LN
Stony Brook, NY 11790-2812
Phone
(631) 232-0011
NPI assigned
Jan 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2015

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

Authorized official

Name
Janine Klein
Title
Cfo
Phone
(631) 232-0011

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary

Addresses

Primary practice location

4 Media LN
Stony Brook, NY 11790-2812

Mailing address

250 Marcus Blvd
P. O. Box 10845
Hauppauge, NY 11788-2018
Phone (631) 232-0011

Other identifiers 1

IdentifierTypeStateIssuer
00717831MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 33H291

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
U C P A OF GREATER SUFFOLK
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Apr 14, 1993
Last certification
May 13, 2025
Beds
6
Ownership / control type
Private (non-profit)
Facility address
4 Media Lane
Stony Brook, NY 11790

National Provider Directory

National Provider Directory
Tax ID family
United Cerebral Palsy Association of Greater Suffolk Inc18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Practitioners & affiliated clinicians

Practitioners 1

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": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437436800000",
    "number": "1346393188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 MARCUS BLVD",
            "address_2": "P. O. BOX 10845",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117882018",
            "telephone_number": "631-232-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MEDIA LN",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902812",
            "telephone_number": "631-232-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED CEREBRAL PALSY ASSOCIATION OF GREATER SUFFOLK, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2015-07-21",
        "status": "A",
        "authorized_official_last_name": "KLEIN",
        "authorized_official_first_name": "JANINE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "631-232-0011"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00717831",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.