NPIMap

Organization Active NPI

Staten Island University Hospital

  • General Acute Care Hospital
  • Staten Island, NY
National Provider Identifier
1407877137
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
7004003H Issued in NY
Legal business name
STATEN ISLAND UNIVERSITY HOSPITAL
Practice address
475 Seaview Ave
Staten Island, NY 10305-3436
Phone
(718) 226-4502
Fax
(718) 226-4875
NPI assigned
Jul 21, 2006
Last updated
Jul 31, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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

Authorized official

Name
Ms. Michele L Cusack
Title
Senior Vice President and Cfo
Phone
(516) 321-6058

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 7004003H NY Primary

Addresses

Primary practice location

475 Seaview Ave
Staten Island, NY 10305-3436

Mailing address

475 Seaview Ave
Staten Island, NY 10305-3436
Phone (718) 226-4502

Other practice location 1

375 Seguine Ave
Staten Island, NY 10309-3932
Phone (718) 226-5797

Electronic endpoints 6

TypeEndpointUseAffiliation
Direct Messaging Address siuhhospscm@northwell.allscriptsdirect.net Health Information Exchange (HIE)
FHIR URL https://fhir.northwell.edu/FHIR Health Information Exchange (HIE)
Direct Messaging Address siuhhospscm@northwell.allscriptsdirect.net Health Information Exchange (HIE)
FHIR URL https://fhir.northwell.edu/FHIR Health Information Exchange (HIE)
CONNECT URL https://172.254.9.13:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark
CONNECT URL https://172.254.9.13:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031215000254 NY Part A Provider - Hospital 8628985504 Practice locations: Brooklyn, NY; Staten Island, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407877137. Details of each certification follow.

Hospital certification: CCN 330160

Legal name
STATEN ISLAND UNIVERSITY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jul 14, 2023
Beds
714
Ownership / control type
Private (not for profit)
Most recent change of ownership
Jun 15, 1987 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Apr 11, 1989 in NY
Enrollment address
475 Seaview Avenue
Staten Island, NY 10305-3436
Main/Primary Hospital Location
Hospital subgroups
General, Acute care, Psychiatric, Rehabilitation

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Staten Island University HospitalCCN 330160 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Staten Island University Hospital21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1 Edgewater St
Ste 3
Staten Island, NY 10305
Phone 7189477000 ext. 7036

Interoperability endpoints

  • Direct secure messaging: siuhhospscm@northwell.allscriptsdirect.net

Ownership & related parties

All disclosed owners & managing parties 25

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

NameRoleSinceShare
William L Mack Individual Corporate Officer Jan 30, 2015
Margaret M Crotty Individual Corporate Officer Jan 1, 2025
Northwell, Inc. Organization, Westbury, NY Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Jul 1, 2024 100%
Harry E Gindi Individual Corporate Officer Jan 1, 2025
Jeffrey a Kraut Individual Corporate Officer Jan 1, 2025
Robert D Rosenthal Individual Corporate Officer Jan 1, 2025
Mark L Claster Individual Corporate Officer Jan 30, 2015
Brian Lally Individual Corporate Officer Jan 1, 2025
Mark J Solazzo Individual Corporate Officer Jan 30, 2015
W-2 Managing Employee Jan 30, 2015
Richard D Goldstein Individual Corporate Officer Jan 30, 2015
Northwell Healthcare Inc Organization, Westbury, NY Corporation, Non-profit, Chain home office 5% Or Greater Direct Ownership Interest Jan 1, 2015 100%
Operational/Managerial Control Mar 1, 1994
David L Battinelli Individual Corporate Officer Jan 1, 2025
Donald Zucker Individual Corporate Officer Jan 30, 2015
Barry Rubenstein Individual Corporate Officer Jan 30, 2015
Northwell Health Inc Organization, Westbury, NY Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Jan 1, 2015 100%
Michael a Epstein Individual Corporate Officer Jan 1, 2025
Mark a. Gloade Individual Corporate Officer Jan 1, 2025
John K D'Angelo Individual Corporate Officer Jan 1, 2025
Donna K Drummond Individual Corporate Officer Jan 1, 2025
Michael J Dowling Individual Corporate Director Jan 30, 2015
W-2 Managing Employee Jan 30, 2015
Laurence a Kraemer Individual Corporate Officer Jan 1, 2025
Konstantine Costalas Individual Corporate Officer Jan 1, 2025
Ralph a Nappi Individual Corporate Officer Jan 30, 2015
Kevin Beiner Individual Corporate Officer Jan 1, 2025
Michele L Cusack Individual Corporate Officer Sep 12, 2017
Corporate Director Sep 12, 2017
W-2 Managing EmployeeSenior Vice President & Cfo Sep 12, 2017

Owners & managing parties with NPI records 3

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

Facilities with the same owner 42

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

View all 42

Practitioners & affiliated clinicians

Practitioners 247

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 247

Affiliated clinicians 1,087

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

View all 1,087

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753920000000",
    "number": "1407877137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053436",
            "telephone_number": "718-226-4502",
            "fax_number": "718-226-4875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053436",
            "telephone_number": "718-226-4502",
            "fax_number": "718-226-4875"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "375 Seguine Ave",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103093932",
            "country_code": "US",
            "telephone_number": "718-226-5797",
            "fax_number": "718-226-4878",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "STATEN ISLAND UNIVERSITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A",
        "authorized_official_last_name": "CUSACK",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT AND CFO",
        "authorized_official_telephone_number": "516-321-6058",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NY",
            "license": "7004003H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "siuhhospscm@northwell.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "Staten Island University Hospital-North MedAllies Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "475 Seaview Ave",
            "city": "Staten Island",
            "state": "NY",
            "country_code": "US",
            "postal_code": "103053436",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.northwell.edu/FHIR",
            "affiliation": "N",
            "endpointDescription": "Staten Island University Hospital-North FHIR API",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "475 Seaview Ave",
            "city": "Staten Island",
            "state": "NY",
            "country_code": "US",
            "postal_code": "103053436",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "siuhhospscm@northwell.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "Staten Island University Hospital-South MedAllies Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "375 Seguine Ave",
            "city": "Staten Island",
            "state": "NY",
            "country_code": "US",
            "postal_code": "103093932",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.northwell.edu/FHIR",
            "affiliation": "N",
            "endpointDescription": "Staten Island University Hospital-South FHIR API",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "375 Seguine Ave",
            "city": "Staten Island",
            "state": "NY",
            "country_code": "US",
            "postal_code": "103093932",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://172.254.9.13:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.1",
            "affiliationName": "Bluemark",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "40 Sunset Ridge Rd",
            "city": "New Paltz",
            "state": "NY",
            "country_code": "US",
            "postal_code": "125611036",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://172.254.9.13:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.1",
            "affiliationName": "Bluemark",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "40 Sunset Ridge Rd",
            "city": "New Paltz",
            "state": "NY",
            "country_code": "US",
            "postal_code": "125611036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.