NPIMap

Organization Active NPI

Nysarc Inc Nyc Chapter

  • Intellectual Disabilities Intermediate Care Facility
  • Jamaica, NY
National Provider Identifier
1487835096
Registry record updated Nov 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
06198494 Issued in NY
Legal business name
NYSARC INC NYC CHAPTER
Practice address
16120 89TH Ave
Apt 3D
Jamaica, NY 11432-3901
Phone
(212) 780-2538
NPI assigned
Nov 26, 2007
Organization subpart
Yes
Parent organization
NYSARC INC NYC CHAPTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 26, 2007

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 06198494 NY Primary

Addresses

Primary practice location

16120 89TH Ave
Apt 3D
Jamaica, NY 11432-3901

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
06198494OtherNYNYS OMRDD
02915066MedicaidNY

National Provider Directory

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

Other organizations with this tax ID 28

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

View all 28

Locations

16120 89th Ave
Apt 3D
Jamaica, NY 11432
Phone (212) 780-2538

NPI Registry JSON

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

{
    "created_epoch": "1196035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196035200000",
    "number": "1487835096",
    "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": "16120 89TH AVE",
            "address_2": "APT 3D",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114323901",
            "telephone_number": "212-780-2538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NYSARC INC NYC CHAPTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NYSARC INC NYC CHAPTER",
        "enumeration_date": "2007-11-26",
        "last_updated": "2007-11-26",
        "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": "NY",
            "license": "06198494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS OMRDD",
            "identifier": "06198494",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02915066",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2007; 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.