NPIMap

Organization Active NPI

Phelps Memorial Hospital

  • Psychiatry Physician
  • Sleepy Hollow, NY
National Provider Identifier
1366786972
Registry record updated Nov 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
PHELPS MEMORIAL HOSPITAL
Practice address
701 N Broadway
Sleepy Hollow, NY 10591-1020
Phone
(914) 366-3000
NPI assigned
Nov 20, 2012
Last updated
Nov 20, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2012

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

Authorized official

Name
Mr. Daniel Blum
Title
Senior VP
Phone
(914) 366-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

701 N Broadway
Sleepy Hollow, NY 10591-1020

Mailing address

155 White Plains Rd
Suite 210a
Tarrytown, NY 10591-5523
Phone (914) 269-1763

Other names 1

  • Phelps Professional Service Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031104000490 NY Part B Supplier - Clinic/Group Practice 1658283981 Receives reassigned benefits from 65 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Croton on Hudson, NY; Sleepy Hollow, NY; Ossining, NY

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory

Locations

155 White Plains Rd
Ste 210A
Tarrytown, NY 10591

NPI Registry JSON

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

{
    "created_epoch": "1353369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353369600000",
    "number": "1366786972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 WHITE PLAINS RD",
            "address_2": "SUITE 210A",
            "city": "TARRYTOWN",
            "state": "NY",
            "postal_code": "105915523",
            "telephone_number": "914-269-1763",
            "fax_number": "914-524-7985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N BROADWAY",
            "city": "SLEEPY HOLLOW",
            "state": "NY",
            "postal_code": "105911020",
            "telephone_number": "914-366-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHELPS MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-20",
        "last_updated": "2012-11-20",
        "status": "A",
        "authorized_official_last_name": "BLUM",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "SENIOR VP",
        "authorized_official_telephone_number": "914-366-1000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phelps Professional Service",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sleepy Hollow, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.