NPIMap

Organization Active NPI

Calvary Hospital Inc.

Doing business as Calvary Hospital Hospice

  • Community Based Hospice Care Agency
  • Bronx, NY
National Provider Identifier
1396756524
Registry record updated Mar 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
7003503F Issued in NY
Legal business name
CALVARY HOSPITAL INC.
Doing business as
Calvary Hospital Hospice
Practice address
1740 Eastchester Rd
Bronx, NY 10461-2300
Phone
(718) 518-2465
NPI assigned
Aug 11, 2006
Last updated
Mar 4, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2015

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

Authorized official

Name
Mr. Andrew V Greco, CPA
Title
Cfo
Phone
(718) 518-2069

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 7003503F NY Primary

Addresses

Primary practice location

1740 Eastchester Rd
Bronx, NY 10461-2300

Mailing address

1740 Eastchester Rd
Bronx, NY 10461-2300

Other identifiers 1

IdentifierTypeStateIssuer
02023403MedicaidNY

Other names 1

  • Calvary Hospital Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120109000481 NY Part A Provider - Hospice 9133010382 Practice locations: Bronx, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396756524. Details of each certification follow.

Hospice certification: CCN 331562

Legal name
CALVARY HOSPITAL INC
Doing business as
CALVARY HOSPTIAL HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jan 14, 1999
Last certification
Nov 22, 2019
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 27, 1900 in NY
Enrollment address
1740 Eastchester Rd
Bronx, NY 10461-2300

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Calvary Home Health Agency and Hospice CareCCN 331562 · All quality measures
Ownership
Other
Certified
Jan 14, 1999
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Lyla J Correoso4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Eric Goldman Individual Contracted Managing EmployeeMedical Director Feb 2, 2024
Joseph Saporito Individual Corporate DirectorBoard Member Feb 2, 2024
Tara a. Cortes Individual Corporate DirectorBoard Member Feb 26, 2024
Frank J Serbaroli Individual Corporate DirectorBoard Member Feb 2, 2024
Jeffrey J Menkes Individual Corporate Director Feb 2, 2024
W-2 Managing Employee Feb 2, 2024
Providence Health Services Inc Organization, New York, NY Non-profit 5% Or Greater Indirect Ownership Interest Sep 25, 2006 100%
Thomas M O'Brien Individual Corporate DirectorBoard Member Feb 26, 2024
Stephen J Bujno Individual Corporate DirectorBoard Member Feb 2, 2024
Kathy Lynch Individual W-2 Managing EmployeeAd; Feb 2, 2024
Andrew Greco Individual Corporate Director Feb 1, 2012
Operational/Managerial Control Feb 1, 2012
Gerald T Sweeney Individual Corporate DirectorBoard Member Feb 2, 2024
Catholic Health Care Systems Organization, New York, NY Non-profit 5% Or Greater Direct Ownership Interest Sep 25, 2006 100%
Karen a Gray Individual Corporate DirectorBoard Member Feb 26, 2024
John F Gleason Individual Corporate DirectorBoard Member Feb 2, 2024
Scott Larue Individual Corporate DirectorBoard Member Feb 2, 2024
Clarion E Johnson Individual Corporate DirectorBoard Member Feb 2, 2024
Carlos Hernandez Individual Corporate DirectorBoard Member Apr 22, 2024

Owners & managing parties with NPI records 1

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

Facilities with the same owner 6

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

Practitioners & affiliated clinicians

Affiliated clinicians 42

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

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425427200000",
    "number": "1396756524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 EASTCHESTER RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 EASTCHESTER RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612300",
            "telephone_number": "718-518-2465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALVARY HOSPITAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2015-03-04",
        "status": "A",
        "authorized_official_last_name": "GRECO",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "718-518-2069",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NY",
            "license": "7003503F",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02023403",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Calvary Hospital Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.