Active NPI
Monsignor Fitzpatrick SN Pavilion
- Nursing Facility/Intermediate Care Facility
- Jamaica, NY
National Provider Identifier
1487868162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Facility/Intermediate Care Facility
- License
- 009683
- Legal business name
- MONSIGNOR FITZPATRICK SN PAVILION
- Practice address
- 15211 89TH Ave
Jamaica, NY 11432-3730 - Phone
- (718) 558-9696
- Fax
- (718) 558-2476
- NPI assigned
- May 10, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Sonia A Gordon
- Title
- Business Office Manager
- Phone
- (718) 558-9696
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | 009683 | NY | Primary |
Addresses
Primary practice location
15211 89TH Ave
Jamaica, NY 11432-3730
Mailing address
15211 89TH Ave
Jamaica, NY 11432-3730
Phone (718) 558-9696
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 335689 | Other | NY | HIP |
| 009683 | Other | NY | BLUE CROSS BLUE SHIELD |
| 01044260 | Medicaid | NY | |
| 169835 | Other | NY | ELDER PLANE |
National Provider Directory
National Provider Directory- Tax ID family
- Caritas Health Care Inc
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Psychiatric Hospital Unit
- Jamaica, NY
- NPI 1811155658
-
- Oral and Maxillofacial Surgery (Dentist)
- Jamaica, NY
- NPI 1316041924
-
- General Acute Care Hospital
- Elmhurst, NY
- NPI 1043362791
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178755200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1214352000000",
"number": "1487868162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15211 89TH AVE",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114323730",
"telephone_number": "718-558-9696",
"fax_number": "718-558-2476"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15211 89TH AVE",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114323730",
"telephone_number": "718-558-9696",
"fax_number": "718-558-2476"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MONSIGNOR FITZPATRICK SN PAVILION",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-10",
"last_updated": "2008-06-25",
"status": "A",
"authorized_official_last_name": "GORDON",
"authorized_official_first_name": "SONIA",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
"authorized_official_telephone_number": "718-558-9696",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": "NY",
"license": "009683",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIP",
"identifier": "335689",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "009683",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01044260",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ELDER PLANE",
"identifier": "169835",
"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 Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.