NPIMap

Organization Active NPI

Kaleida Health

  • General Acute Care Hospital
  • Buffalo, NY
National Provider Identifier
1366473183
Registry record updated Jul 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
1401014H Issued in NY
Legal business name
KALEIDA HEALTH
Practice address
100 High St
Buffalo, NY 14203-1126
Phone
(716) 859-1993
NPI assigned
Jul 6, 2006
Last updated
Jul 10, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2007

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

Authorized official

Name
Joanne Puccio
Title
Crentialing Ar Receivables Manager
Phone
(716) 859-8396

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 1401014H NY Primary

Addresses

Primary practice location

100 High St
Buffalo, NY 14203-1126

Mailing address

100 High St
Buffalo, NY 14203-1126
Phone (716) 859-1993

Other identifiers 3

IdentifierTypeStateIssuer
00360614MedicaidNY
00361968MedicaidNY
00384643MedicaidNY

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031105000212 NY Part B Supplier - Clinic/Group Practice 7810805280 Receives reassigned benefits from 712 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Buffalo, NY; N Tonawanda, NY; New York, NY; North Tonawanda, NY; Olean, NY; Pleasantville, NY; Poughkeepsie, NY; Williamsville, NY…
O20040324000835 NY Part A Provider - Hospital 7810805280 5 other NPIs on this enrollment
Practice locations: Buffalo, NY; Williamsville, NY; North Tonawanda, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1366473183. Details of each certification follow.

Hospital certification: CCN 330005

Legal name
KALEIDA HEALTH
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Sep 23, 2022
Beds
986
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
100 High St
Buffalo, NY 14203-1126
Main/Primary Hospital Location
Hospital subgroups
General

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

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 9

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Kaleida HealthCCN 330005 · 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

Locations

445 Tremont St
#705
North Tonawanda, NY 14120
Phone (716) 694-4500

Ownership & related parties

All disclosed owners & managing parties 32

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

NameRoleSinceShare
Matthew D Drake Individual Corporate OfficerEvp Strategy & Partnerships Dec 5, 2021
W-2 Managing EmployeeChief Financial Officer Dec 5, 2021
Timothy M. Adams Individual Corporate DirectorBoard Member Dec 1, 2023
Corin Silvestrini Individual W-2 Managing EmployeePayer Credentialing Supervisor Feb 1, 2024
Mary Lou Rusin Individual Corporate Director May 1, 2015
Ian Barrett Individual Corporate OfficerChief Human Resources Officer Oct 1, 2022
Jo Ann Ormond Individual W-2 Managing EmployeeDirector Patient Financial Services Aug 19, 2019
Donald Boyd Individual Corporate OfficerPresident, Chief Executive Officer Jul 11, 2022
Corporate DirectorBoard Member Jul 11, 2022
W-2 Managing EmployeePresident, Chief Executive Officer May 1, 2009
Paul O'Leary Individual Corporate Director Apr 1, 2018
Jennifer Dunn Individual W-2 Managing EmployeeRegional Contracting Director Mar 1, 2024
Timothy G McEvoy Individual Corporate DirectorBoard Member Jun 1, 2019
Kenneth V Snyder Individual W-2 Managing EmployeeChief Physician Quality Officer Apr 1, 2022
Michael P Hughes Individual Corporate OfficerSenior VP, Chief Admin Officer Sep 1, 2004
Prudential Huntoon Paige Associated LTD Isaoa Organization, Dallas, TX Financial institution 5% Or Greater Mortgage Interest Apr 1, 1998 33%
K Kent Chevli Individual Corporate DirectorBoard Member Apr 1, 2022
George E Matthews Individual Corporate Director May 1, 2008
Shannon Bryant Individual Corporate OfficerChief Diversity & Inclusion Officer Dec 1, 2020
Alyson Spaulding Individual Corporate OfficerGeneral Counsel Aug 1, 2014
Jamie N Nadler Individual W-2 Managing EmployeeChief Quality Officer May 1, 2022
Thomas Beauford Individual Corporate DirectorBoard Member Apr 12, 2022
Christopher D Ross Individual Corporate Director May 1, 2015
Lorrie Clemo Individual Corporate DirectorBoard Member May 1, 2017
Abeer Eddib Individual Corporate DirectorBoard Member Jun 1, 2019
Dan Magnuszewski Individual Corporate DirectorBoard Member Apr 1, 2024
Kaleida Health Organization, Buffalo, NY Corporation, Non-profit 5% Or Greater Direct Ownership Interest Apr 1, 1998 100%
Michael J Mineo Individual Corporate OfficerChief Medical Officer Oct 1, 2023
John Persons Individual Corporate Director Apr 1, 2022
Gary Crosby Individual Corporate DirectorBoard Chairman May 1, 2017
Marjorie Quint-Bouzid Individual Corporate OfficerChief Nurse Executive Oct 1, 2023
Muhammed Javed Individual Corporate DirectorBoard Member May 1, 2019
Hugh Chisholm Individual Corporate OfficerEvp, Cfo Oct 18, 2023
Michael McMahon Individual Corporate DirectorBoard Member Dec 1, 2023
Angela McCrorey Individual W-2 Managing EmployeeSupervisor Patient Financial Servic Jun 1, 2019

Owners & managing parties with NPI records 16

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

View all 16

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Kaleida HealthBuffalo, NY, CCN 33T005 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1998
Degraff Memorial Hospital-Skilled Nursing FacilityNorth Tonawanda, NY, CCN 335669 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1998
Highpointe on Michigan HCFBuffalo, NY, CCN 335834 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 3, 2011
Visiting Nursing Association of Western New York, Inc.Cheektowaga, NY, CCN 337006 Home health agency 5% Or Greater Direct Ownership Interest Jan 9, 2007

Owned or controlled facilities with NPI records 9

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 4

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

Practitioners & affiliated clinicians

Practitioners 188

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 188

Affiliated clinicians 1,723

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

View all 1,723

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184025600000",
    "number": "1366473183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HIGH ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031126",
            "telephone_number": "716-859-1993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HIGH ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031126",
            "telephone_number": "716-859-1993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KALEIDA HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2007-07-10",
        "status": "A",
        "authorized_official_last_name": "PUCCIO",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_title_or_position": "CRENTIALING AR RECEIVABLES MANAGER",
        "authorized_official_telephone_number": "716-859-8396"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NY",
            "license": "1401014H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00360614",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00361968",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00384643",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.