NPIMap

Organization Active NPI

United Cerebral Palsy Assoc of Nys Inc

Doing business as Cerebral Palsy of NYS

  • Clinic/Center
  • Staten Island, NY
National Provider Identifier
1376600551
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
UNITED CEREBRAL PALSY ASSOC OF NYS INC
Doing business as
Cerebral Palsy of NYS
Constructive Partnerships Unlimited
Practice address
Koicheff Health Care Center
2324 Forest Ave
Staten Island, NY 10303
Phone
(718) 447-0200
Fax
(718) 981-1431
NPI assigned
Jan 3, 2007
Last updated
Nov 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Authorized official

Name
Thomas Mandelkow
Title
Executive VP
Phone
(646) 235-1282

Specialties & licenses 1

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

Addresses

Primary practice location

Koicheff Health Care Center
2324 Forest Ave
Staten Island, NY 10303

Mailing address

40 Rector St FL 15
New York, NY 10006-1722
Phone (929) 647-4796

Other identifiers 1

IdentifierTypeStateIssuer
03006282MedicaidNY

Other names 2

  • Cerebral Palsy of NYS Doing business as
  • Constructive Partnerships Unlimited Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040420000110 NY Part B Supplier - Clinic/Group Practice 0749275584 Receives reassigned benefits from 26 practitioners
5 other NPIs on this enrollment
Practice locations: Bronx, NY; Brooklyn, NY; Long Island City, NY; Oakland Gardens, NY; Staten Island, NY

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory
Tax ID family
Cerebral Palsy of Nys32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

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

View all 31

Practitioners & affiliated clinicians

Practitioners 27

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 27

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763424000000",
    "number": "1376600551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 RECTOR ST FL 15",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100061722",
            "telephone_number": "929-647-4796",
            "fax_number": "212-356-1348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "KOICHEFF HEALTH CARE CENTER",
            "address_2": "2324 FOREST AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10303",
            "telephone_number": "718-447-0200",
            "fax_number": "718-981-1431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED CEREBRAL PALSY ASSOC OF NYS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A",
        "authorized_official_last_name": "MANDELKOW",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "EXECUTIVE VP",
        "authorized_official_telephone_number": "646-235-1282"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03006282",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cerebral Palsy of NYS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Constructive Partnerships Unlimited",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2025; 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.