NPIMap

Organization Active NPI

Rome Memorial Hospital, Inc

Doing business as Regional Wound Care Center

  • Clinic/Center
  • Rome, NY
National Provider Identifier
1356689004
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
ROME MEMORIAL HOSPITAL, INC
Doing business as
Regional Wound Care Center
Practice address
267 Avery LN Ste 200
Rome, NY 13441-4240
Phone
(315) 338-7540
Fax
(315) 338-7538
NPI assigned
Jan 30, 2013
Last updated
Jul 10, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
ROME MEMORIAL HOSPITAL, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Authorized official

Name
Ann Marie Czyz
Title
President/Ceo
Phone
(315) 337-1200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

267 Avery LN Ste 200
Rome, NY 13441-4240

Mailing address

1500 N James St
Rome, NY 13440-2844
Phone (315) 337-1200

Other identifiers 1

IdentifierTypeStateIssuer
03974265MedicaidNY

Other names 1

  • Regional Wound Care Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20021021000020 NY Part A Provider - Hospital 9638087273 7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Boonville, NY; Camden, NY; Rome, NY
O20040719001470 NY Part B Supplier - Clinic/Group Practice 9638087273 Receives reassigned benefits from 56 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Camden, NY; Rome, NY; Boonville, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1356689004. Details of each certification follow.

Hospital certification: CCN 330215

Legal name
ROME MEMORIAL HOSPITAL, INC.
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Oct 10, 2024
Beds
144
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Dec 23, 1994 in NY
Enrollment address
1500N James St
Rome, NY 13440-2844
Other Hospital Practice Location
Hospital subgroups
Psychiatric, Rehabilitation, Short-term

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 11

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Rome Memorial Hospital, IncCCN 330215 · All quality measures
Overall star rating
2 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
Rome Memorial Hospital Inc11 organizations share this tax ID, including this one
Part of
Rome Memorial Hospital Inc

Other organizations with this tax ID 10

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

Locations

155 W Dominick St
Rome, NY 13440
Phone (315) 338-7057

267 Avery Ln
Ste 200
Rome, NY 13441
Phone (315) 338-7540

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Lynn Reese Individual Corporate DirectorVice Chair Dec 12, 2007
Ryan Thompson Individual Corporate DirectorChief Operations Officer Mar 15, 2020
Anne Marie Czyz Individual Corporate DirectorChief Executive Officer Mar 1, 2021
Valerie Finster Individual Corporate DirectorDirector Patient Accounts Nov 1, 2021
Julie Grow Denton Individual Corporate DirectorTreasurer Jan 11, 2011
Ankur M Desai Individual Corporate OfficerChairman Jan 1, 2020
Kristin Grunder Individual Corporate DirectorAssistant Secretary Oct 24, 2017
Ryan O-Shaughnessy Individual Corporate DirectorAssisstant Treasurer Aug 29, 2017
Darlene Burns Individual Corporate DirectorSecretary Mar 29, 2016
John R Restivo Individual Corporate Officer Jan 1, 2020
Nathan Smith Individual Corporate DirectorAvp Finance Jul 1, 2025 5%
W-2 Managing EmployeeAvp Finance Jul 1, 2025
Operational/Managerial ControlAvp Finance Jul 1, 2025

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 7

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.

Affiliated clinicians 337

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

View all 337

NPI Registry JSON

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

{
    "created_epoch": "1359504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688947200000",
    "number": "1356689004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 N JAMES ST",
            "city": "ROME",
            "state": "NY",
            "postal_code": "134402844",
            "telephone_number": "315-337-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 AVERY LN STE 200",
            "city": "ROME",
            "state": "NY",
            "postal_code": "134414240",
            "telephone_number": "315-338-7540",
            "fax_number": "315-338-7538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROME MEMORIAL HOSPITAL, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ROME MEMORIAL HOSPITAL, INC",
        "enumeration_date": "2013-01-30",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A",
        "authorized_official_last_name": "CZYZ",
        "authorized_official_first_name": "ANN MARIE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "315-337-1200"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03974265",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Regional Wound Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Regional Wound Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rome, NY

Sources for this page

Verify at the official NPI Registry.