NPIMap

Organization Active NPI

Monsignor Fitzpatrick SN Pavilion

  • Skilled Nursing Facility
  • Jamaica, NY
National Provider Identifier
1396731279
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MONSIGNOR FITZPATRICK SN PAVILION
Practice address
15211 89TH Ave
Jamaica, NY 11432-3730
Phone
(718) 558-2870
Fax
(718) 558-2476
NPI assigned
Sep 26, 2005
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Melvin Aaron
Title
Administrator
Phone
(718) 558-2870

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NY Primary

Addresses

Primary practice location

15211 89TH Ave
Jamaica, NY 11432-3730

Mailing address

15211 89TH Ave
Jamaica, NY 11432-3730
Phone (718) 558-2870

Other identifiers 2

IdentifierTypeStateIssuer
009683OtherNYEMPIRE BC & BS
01044260MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Catholic Medical Center of Brooklyn and Queens8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

NPI Registry JSON

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1396731279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15211 89TH AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114323730",
            "telephone_number": "718-558-2870",
            "fax_number": "718-558-2476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15211 89TH AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114323730",
            "telephone_number": "718-558-2870",
            "fax_number": "718-558-2476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONSIGNOR FITZPATRICK SN PAVILION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-26",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "AARON",
        "authorized_official_first_name": "MELVIN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "718-558-2870",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC & BS",
            "identifier": "009683",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01044260",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.