NPIMap

Organization Active NPI

Clifton Springs Sanitarium Co

Doing business as Clifton Springs Hospital and Clinic

  • General Acute Care Hospital
  • Clifton Springs, NY
National Provider Identifier
1366505463
Registry record updated Jan 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
3421000H Issued in NY
Legal business name
CLIFTON SPRINGS SANITARIUM CO
Doing business as
Clifton Springs Hospital and Clinic
Practice address
2 Coulter Rd
Clifton Springs, NY 14432-1122
Phone
(315) 462-9561
Fax
(315) 462-3492
NPI assigned
Dec 19, 2006
Last updated
Jan 15, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2020

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

Authorized official

Name
Patricia J Patton, RN, BSN
Title
Manager Provider Enrollment
Phone
(585) 922-0527

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Hospital Unit 276400000X NU
General Acute Care Hospital 282N00000X 3421000H NY Primary
Long Term Care Pharmacy 3336L0003X NU

Addresses

Primary practice location

2 Coulter Rd
Clifton Springs, NY 14432-1122

Mailing address

100 Kings Highway South
Rochester, NY 14617-5504
Phone (315) 462-9561

Other identifiers 1

IdentifierTypeStateIssuer
00354641MedicaidNY

Other names 1

  • Clifton Springs Hospital and Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040507000695 NY Part B Supplier - Clinic/Group Practice 5092704809 Receives reassigned benefits from 27 practitioners
Practice locations: Clifton Springs, NY
O20040525000569 NY Part B Supplier - Clinic/Group Practice 5092704809 Receives reassigned benefits from 987 practitioners
Practice locations: Newark, NY; Victor, NY; Syracuse, NY; Macedon, NY; Geneva, NY; Clifton Springs, NY
O20070328000138 NY Part A Provider - Hospital 5092704809 Practice locations: Clifton Springs, NY; Macedon, NY; Newark, NY; Canandaigua, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1366505463. Details of each certification follow.

Hospital certification: CCN 330265

Legal name
CLIFTON SPRINGS SANITARIUM CO
Doing business as
CLIFTON SPRINGS HOSPITAL AND CLINIC
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Feb 16, 2023
Beds
154
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Apr 5, 1854 in NY
Enrollment address
2 Coulter Rd
Clifton Springs, NY 14432-1122
Other Hospital Practice Location
Hospital subgroups
General

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

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Clifton Springs Hospital and ClinicCCN 330265 · 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

Locations

35 North St
Canandaigua, NY 14424
Phone (585) 349-0530

468 S Pearl St
Canandaigua, NY 14424
Phone (585) 218-0072

833 Canandaigua Rd
Geneva, NY 14456
Phone (315) 210-1331

1900 State Route 31
Macedon, NY 14502
Phone (315) 986-1336

1900 State Route 31
Ste 11
Macedon, NY 14502
Phone (315) 986-1336

165 E Union St
Newark, NY 14513
Phone (315) 331-0810

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Kayvan Mirhadi Individual Corporate DirectorBoard Member Jul 1, 2019
Sidney H Sobel Individual Corporate OfficerBoard Member Feb 26, 2004
Corporate DirectorBoard Member Jan 1, 2007
Nichole S Holder Individual W-2 Managing EmployeeManager, Patient Financial Services Apr 1, 2015
Richard O Davis Individual Corporate Director Mar 1, 2022
Lisa Mattoon Individual Corporate Officer Jul 1, 2021
William W Young Individual Corporate OfficerBoard Member Mar 3, 1994
Corporate DirectorBoard Member Jan 1, 2007
Howard Glastonbury Individual Corporate OfficerVP Cfo Corporate Finance Jan 1, 2020
Robert a Woodhouse Individual Corporate OfficerBoard Member Jan 1, 1984
Corporate DirectorBoard Member Jan 1, 2007
Nicholas Day Individual Corporate DirectorBoard Member Jul 1, 2019
Dustin M Riccio Individual Corporate OfficerPresident of Regional Operations Apr 1, 2015
W-2 Managing EmployeePresident of Regional Operations Apr 1, 2015
Joseph Miles Individual W-2 Managing Employee Oct 22, 2001
Holly Adams Individual Corporate DirectorBoard Member Jan 24, 2017
Dina Stuck Individual Corporate DirectorBoard Member Jul 1, 2019
Kerry Adams Individual Corporate DirectorBoard Member Jan 24, 2017
Bonnie Ross Individual Corporate DirectorBoard Member Jul 1, 2018
Sally Mueller Individual Corporate DirectorBoard Member Jan 24, 2017
Thomas R Crilly Individual Corporate OfficerExecutive Vice Presiddent, Cfo Apr 1, 2015
W-2 Managing EmployeeExecutive Vice President, Cfo Apr 1, 2015
Stephen M Ignaczak Individual Corporate OfficerBoard Member Aug 28, 2008
Corporate DirectorBoard Member Aug 28, 2008

Owners & managing parties with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 1,035

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 1,035

Affiliated clinicians 372

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

View all 372

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579046400000",
    "number": "1366505463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGS HIGHWAY SOUTH",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146175504",
            "telephone_number": "315-462-9561",
            "fax_number": "315-462-3492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 COULTER RD",
            "city": "CLIFTON SPRINGS",
            "state": "NY",
            "postal_code": "144321122",
            "telephone_number": "315-462-9561",
            "fax_number": "315-462-3492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLIFTON SPRINGS SANITARIUM CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A",
        "authorized_official_last_name": "PATTON",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MANAGER PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "585-922-0527",
        "authorized_official_credential": "RN, BSN"
    },
    "taxonomies": [
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NY",
            "license": "3421000H",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00354641",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clifton Springs Hospital and Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clifton Springs Hospital and Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clifton Springs, NY

Sources for this page

Verify at the official NPI Registry.