NPIMap

Organization Active NPI

Cayuga Medical Center at Ithaca

  • Rehabilitation Hospital Unit
  • Ithaca, NY
National Provider Identifier
1366519795
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
Legal business name
CAYUGA MEDICAL CENTER AT ITHACA
Practice address
101 Dates Dr
Ithaca, NY 14850-1342
Phone
(607) 274-4011
Fax
(607) 274-4527
NPI assigned
Nov 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Authorized official

Name
Rebecca Gould
Title
Cfo
Phone
(607) 274-4011

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X Primary

Addresses

Primary practice location

101 Dates Dr
Ithaca, NY 14850-1342

Mailing address

101 Dates Dr
Ithaca, NY 14850-1342
Phone (607) 274-4011

Other identifiers 4

IdentifierTypeStateIssuer
00332729MedicaidNY
00011438301OtherNYUNIVERA PROVIDER NO
365593OtherNYMVP PROVIDER NO
5401001HOtherNYNYS PROVIDER OPER CERT NO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121121000213 NY Part A Provider - Hospital 7214847367 Practice locations: Ithaca, NY

Hospital certification: CCN 33T307

Legal name
CAYUGA MEDICAL CENTER AT ITHACA
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1981 in NY
Enrollment address
101 Dates Dr
Ithaca, NY 14850-1383
Other Hospital Practice Location
Hospital subgroups
Rehabilitation

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

Other NPIs with the same Medicare PAC ID 4

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

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Cayuga Medical Ctr @ IthacaCCN 33T307
Ownership
Non-profit
Certified
Jan 1, 1997

National Provider Directory

National Provider Directory
Tax ID family
Tompkins County Hospita5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Ownership & related parties

All disclosed owners & managing parties 22

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

NameRoleSinceShare
Krista Niles-Updyke Individual Corporate DirectorBoard Member Jan 1, 2025
Martin Stallone Individual Corporate OfficerCeo/Ex-Officio Jan 1, 2020
Corporate DirectorBoard of Directors Member Apr 1, 2018
Operational/Managerial ControlCeo Jan 1, 2023
Joel Malina Individual Corporate DirectorBoard of Directors Secretary Apr 1, 2018
Arie Van Den Blink Individual Corporate DirectorBoard Member Jan 1, 2025
Paul Streeter Individual Corporate DirectorBoard Member Jan 1, 2023
Suzanne Blowers Individual Corporate OfficerSecretary Jan 1, 2023
Corporate DirectorBoard of Directors Member Apr 1, 2018
Jennifer Whittaker Individual Corporate DirectorBoard Member Jan 1, 2023
Thomas P Livigne Individual Corporate OfficerChair Jan 1, 2023
Corporate DirectorBoard of Directors Member Apr 1, 2018
Cayuga Health System Inc Organization, Ithaca, NY Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jun 13, 2014 100%
Operational/Managerial Control Jun 13, 2014 100%
John-Paul Daniel Mead Individual Corporate DirectorBoard Member Jan 1, 2023
Yvette Conyers Individual Corporate Director Jan 1, 2023
Karen Callanan Individual Corporate DirectorBoard Member Jan 1, 2025
La Jerne Terry Cornish, PH.D. Individual Corporate DirectorBoard Member Jan 1, 2023
Centralus Health Inc Organization, Ithaca, NY Non-profit 5% Or Greater Indirect Ownership Interest Jan 1, 2025 100%
Cris Donovan Individual Corporate DirectorBoard Member Jan 1, 2023
Gary a Koretzky Individual Corporate DirectorBoard Member Jan 1, 2023
R.Brooke Hollis Individual Corporate DirectorBoard Member Jan 1, 2023
Melissa Joy Schmidt Individual Corporate DirectorBoard Member Jan 1, 2025
Laurie J Mante Individual Corporate DirectorBoard Member Jan 1, 2023
Rebecca Gould Individual Corporate OfficerChief Financial Officer Jan 1, 2025
Eunice Nayo Individual Corporate DirectorBoard of Directors Member Apr 1, 2018
Sandra Iberger Individual Corporate DirectorBoard Member Jan 1, 2025

Owners & managing parties with NPI records 3

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Cayuga Medical Center at IthacaIthaca, NY, CCN 33U307 Hospital Operational/Managerial Control Aug 13, 2012

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 5

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

Practitioners & affiliated clinicians

Practitioners 35

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 35

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744761600000",
    "number": "1366519795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 DATES DR",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501342",
            "telephone_number": "607-274-4011",
            "fax_number": "607-274-4527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DATES DR",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501342",
            "telephone_number": "607-274-4011",
            "fax_number": "607-274-4527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAYUGA MEDICAL CENTER AT ITHACA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A",
        "authorized_official_last_name": "GOULD",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "607-274-4011"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00332729",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA PROVIDER NO",
            "identifier": "00011438301",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP PROVIDER NO",
            "identifier": "365593",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS PROVIDER OPER CERT NO",
            "identifier": "5401001H",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.