NPIMap

Organization Active NPI

Ozanam Hall of Queens Nursing Home, Inc

  • Skilled Nursing Facility
  • Bayside, NY
National Provider Identifier
1396825543
Registry record updated Nov 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
OZANAM HALL OF QUEENS NURSING HOME, INC
Practice address
4241 201St St
Bayside, NY 11361-2550
Phone
(718) 423-2000
Fax
(718) 971-2071
NPI assigned
Oct 16, 2006
Last updated
Nov 10, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2009

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

Authorized official

Name
Philip Ann Bowden, LNHA
Title
Administrator
Phone
(718) 423-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

4241 201St St
Bayside, NY 11361-2550

Mailing address

4241 201St St
Bayside, NY 11361-2550
Phone (718) 423-2000

Other identifiers 4

IdentifierTypeStateIssuer
1670OtherNYPFI NUMBER
00309691OtherNYMEDICAID PROVIDER NUMBER
1396825543OtherNYNPI
7003306NMedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100828000129 NY Part B Supplier - Clinic/Group Practice 6709928344 Receives reassigned benefits from 1 practitioner
Practice locations: Bayside, NY
O20111103000252 NY Part A Provider - Skilled Nursing Facility 6709928344 Practice locations: Bayside, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396825543. Details of each certification follow.

Skilled nursing facility certification: CCN 335363

Legal name
OZANAM HALL OF QUEENS NURSING HOME, INC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 10, 1972
Last certification
Oct 3, 2024
Beds
432
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 14, 1967 in NY
Enrollment address
42-41 201St Street
Bayside, NY 11361-2550
Nursing home name
OZANAM HALL OF QUEENS NURSING HOME INC
Affiliated entity
CARMELITE SISTERS FOR THE AGED AND INFIRMED

Care Compare: Nursing home

Medicare Care Compare
Listed as
Ozanam Hall Of Queens Nursing Home IncCCN 335363 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Sep 10, 1972
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
432406.3 residents per day on average
Chain
Carmelite Sisters for the Aged and Infirmed3 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0671076Ozanam Hall of Queens Nursing Home42-41 201St Street, Bayside, NY 11361Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 21

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

NameRoleSinceShare
Rose Kasper Individual Corporate DirectorBoard Member Mar 1, 2015
Margaret a Haley Individual Corporate Officer Apr 9, 2025
Corporate DirectorBoard Member Apr 9, 2025
Leda Domino Individual Corporate Director Apr 9, 2025
Patricia Gathers Individual Corporate OfficerCeo of the Carmelite System Jul 1, 2021
Sharad N Soni Individual Operational/Managerial Control Dec 1, 2024
Adp of the SNF Dec 1, 2024
Leslee a Devlin Individual Corporate DirectorBoard Member Jun 11, 2007
Robert John Brennan Individual Corporate DirectorMember - Co-Sponsor Nov 30, 2021
The Carmelite System, Inc. Organization, Germantown, NY Corporation, Management services company, Non-profit Operational/Managerial Control Jan 10, 2013
Adp of the SNF Dec 1, 2025
Mary Clare Heery Individual Corporate OfficerPresident of Board Mar 1, 2015
Corporate DirectorBoard Member Mar 1, 2015
Keith Powers Individual Corporate Director Mar 4, 1997
Diane Randall Individual Corporate DirectorBoard Member Jan 1, 2008
Patricia Lynch Individual Corporate Director May 2, 1989
Roman Catholic Disocese of Brooklyn Organization, Brooklyn, NY Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Mar 18, 1969 50%
Adp of the SNF Jun 14, 1967
Joseph Fonti Individual Corporate OfficerVice President of Board May 9, 2023
Patrica Reilly Individual Corporate Director Dec 1, 2013
Mary B Bowden Individual Corporate OfficerAdministrator Mar 1, 2015
Operational/Managerial Control Mar 1, 2015
Adp of the SNF Mar 1, 2015
Carmelite Sisters for the Aged and Infirm, Inc. Organization, Germantown, NY Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jun 14, 1967 50%
Adp of the SNF Jun 14, 1967
Sean Gerard Ogle Individual Corporate Director Apr 9, 2025
Marty McAleer Individual Corporate Director Jun 1, 2018
Theresa Pfeffer Individual Corporate Director Dec 11, 2023
Patrick J Keating Individual Corporate OfficerTreasurer of Board May 27, 2020

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 2

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

Practitioners & affiliated clinicians

Practitioners 14

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 14

Affiliated clinicians 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257811200000",
    "number": "1396825543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4241 201ST ST",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113612550",
            "telephone_number": "718-423-2000",
            "fax_number": "718-971-2071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4241 201ST ST",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113612550",
            "telephone_number": "718-423-2000",
            "fax_number": "718-971-2071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OZANAM HALL OF QUEENS NURSING HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2009-11-10",
        "status": "A",
        "authorized_official_last_name": "BOWDEN",
        "authorized_official_first_name": "PHILIP ANN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "718-423-2000",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PFI NUMBER",
            "identifier": "1670",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID PROVIDER NUMBER",
            "identifier": "00309691",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1396825543",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7003306N",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

Verify at the official NPI Registry.