NPIMap

Organization Active NPI

Schuyler Hospital Inc

  • Rural Health Clinic/Center
  • Montour Falls, NY
National Provider Identifier
1417580697
Registry record updated Mar 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SCHUYLER HOSPITAL INC
Practice address
220 Steuben St
Montour Falls, NY 14865-9740
Phone
(607) 535-7154
Fax
(607) 535-7157
NPI assigned
Feb 17, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2020

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

Authorized official

Name
Malia Popovich
Title
Physician Billing Supervisor
Phone
(607) 535-8639

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

220 Steuben St
Montour Falls, NY 14865-9740

Mailing address

220 Steuben St
Montour Falls, NY 14865-9740
Phone (607) 535-8639

Other names 1

  • Montour Rural Health Clinic Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200402000459 NY Part A Provider - Rural Health Clinic 3577548262 Practice locations: Montour Falls, NY

Rural health clinic certification: CCN 338501

Legal name
SCHUYLER HOSPITAL INC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 21, 2022
Last certification
Jan 16, 2025
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Nov 22, 1920 in NY
Enrollment address
220 Steuben St
Montour Falls, NY 14865-9740
Related CCNs
331313

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).

National Provider Directory

National Provider Directory
Tax ID family
Lambert T Parker MD5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the 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
Larry F Baum Individual Corporate Director May 1, 2016
Jerry Mickelson Individual Corporate Director May 1, 2016
John Lambert Individual Corporate Director May 1, 2016
Martin Stallone Individual Corporate DirectorPresident and Ceo CHS Bod Sep 1, 2019
Carl Sgrecci Individual Corporate Director May 1, 2016
Joel Malina Individual Corporate Director May 1, 2016
Fred Wickham Individual Corporate Director May 1, 2016
Deborah Alice Bailey Individual Corporate OfficerExec. Director of Patient Care Serv Jun 18, 1990
Suzanne Blowers Individual Corporate Director May 1, 2016
James Brown Individual Corporate Director May 1, 2016
Paula Younger Individual Corporate Director May 1, 2016
Thomas P Livigne Individual Corporate DirectorSecretary May 1, 2016
Kristin Hall Individual Operational/Managerial ControlClinical Ops Manager Jan 2, 2017
Gary Ferguson Individual Corporate Director May 1, 2016
Jackie Collins Individual Operational/Managerial ControlPatient Experiance Manager & Clinic Feb 4, 2004
Matthew Rouff Individual Corporate OfficerExec. Director Outpatient and Suppo Jul 13, 2015
Benjamin J Saks Individual Corporate Director May 1, 2016
Kenneth Clarke Individual Corporate Director May 1, 2016
Rebecca Gould Individual Corporate OfficerPresident and Ceo Feb 7, 2020
Eunice Nayo Individual Corporate Director May 1, 2016
Greg Hartz Individual Corporate DirectorTreasurer May 1, 2016

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 41

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1581897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583193600000",
    "number": "1417580697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 STEUBEN ST",
            "city": "MONTOUR FALLS",
            "state": "NY",
            "postal_code": "148659740",
            "telephone_number": "607-535-8639",
            "fax_number": "604-535-4433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 STEUBEN ST",
            "city": "MONTOUR FALLS",
            "state": "NY",
            "postal_code": "148659740",
            "telephone_number": "607-535-7154",
            "fax_number": "607-535-7157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCHUYLER HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-17",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A",
        "authorized_official_last_name": "POPOVICH",
        "authorized_official_first_name": "MALIA",
        "authorized_official_title_or_position": "PHYSICIAN BILLING SUPERVISOR",
        "authorized_official_telephone_number": "607-535-8639"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Montour Rural Health Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Montour Falls, NY

Sources for this page

Verify at the official NPI Registry.