NPIMap

Organization Active NPI

South Beach Psychiatric Center

  • Health Maintenance Organization
  • Staten Island, NY
National Provider Identifier
1386701506
Registry record updated Aug 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
Legal business name
SOUTH BEACH PSYCHIATRIC CENTER
Practice address
777 Seaview Ave
Staten Island, NY 10305-3436
Phone
(718) 667-2300
NPI assigned
Jan 3, 2007
Organization subpart
Yes
Parent organization
NYS OFFICE OF MENTAL HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 1, 2008

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

Authorized official

Name
Robert Puccio
Title
Director, Finance
Phone
(518) 473-0795

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X NY Primary

Addresses

Primary practice location

777 Seaview Ave
Staten Island, NY 10305-3436

Mailing address

44 Holland Ave
Albany, NY 12229-0001

Other identifiers 1

IdentifierTypeStateIssuer
01618799MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Middletown Psychiatric Center146 organizations share this tax ID, including this one
Part of
Middletown Psychiatric Center

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

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": "1217548800000",
    "number": "1386701506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 HOLLAND AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122290001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053436",
            "telephone_number": "718-667-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BEACH PSYCHIATRIC CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NYS OFFICE OF MENTAL HEALTH",
        "enumeration_date": "2007-01-03",
        "last_updated": "2008-08-01",
        "status": "A",
        "authorized_official_last_name": "PUCCIO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "DIRECTOR, FINANCE",
        "authorized_official_telephone_number": "518-473-0795"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01618799",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Aug 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.