NPIMap

Organization Active NPI

Nysarc Inc Nyc Chapter

  • Intellectual Disabilities Intermediate Care Facility
  • Staten Island, NY
National Provider Identifier
1477620581
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
NYSARC INC NYC CHAPTER
Practice address
55 Galloway Ave
Staten Island, NY 10302-2527
Phone
(212) 780-2631
Fax
(212) 777-5893
NPI assigned
Nov 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Robert C Goldsmith
Title
Chief Operating Officer
Phone
(212) 780-2692

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary

Addresses

Primary practice location

55 Galloway Ave
Staten Island, NY 10302-2527

Mailing address

83 Maiden LN
11 TH Floor
New York, NY 10038-4812
Phone (212) 780-2631

Other identifiers 2

IdentifierTypeStateIssuer
00356794MedicaidNY
6198444OtherNYNYS OMRDD OPERATING CERT

National Provider Directory

National Provider Directory
Tax ID family
Nysarc Inc New York City Chapter29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477620581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 MAIDEN LN",
            "address_2": "11 TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100384812",
            "telephone_number": "212-780-2631",
            "fax_number": "212-777-5893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 GALLOWAY AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103022527",
            "telephone_number": "212-780-2631",
            "fax_number": "212-777-5893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NYSARC INC NYC CHAPTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOLDSMITH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "212-780-2692",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00356794",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS OMRDD OPERATING CERT",
            "identifier": "6198444",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.