NPIMap

Organization Active NPI

Nyfoundling Hospital Aka St Agathas Pelham Manor Icf

  • Intellectual Disabilities Intermediate Care Facility
  • Pelham Manor, NY
National Provider Identifier
1497894414
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
07107440 Issued in NY
Legal business name
NYFOUNDLING HOSPITAL AKA ST AGATHAS PELHAM MANOR ICF
Practice address
1 Shoreview Circle
Pelham Manor
Pelham Manor, NY 10803
Phone
(212) 633-9300
NPI assigned
Feb 6, 2007
Last updated
Aug 22, 2020By the provider in NPPES
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. William F Baccaglini
Title
Executive Director
Phone
(212) 886-4075

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 07107440 NY Primary

Addresses

Primary practice location

1 Shoreview Circle
Pelham Manor
Pelham Manor, NY 10803

Mailing address

590 Avenue of the Americas
New York, NY 10011
Phone (212) 727-6977

Other identifiers 1

IdentifierTypeStateIssuer
00518754MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
New York Foundling26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497894414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 AVENUE OF THE AMERICAS",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10011",
            "telephone_number": "212-727-6977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SHOREVIEW CIRCLE",
            "address_2": "PELHAM MANOR",
            "city": "PELHAM MANOR",
            "state": "NY",
            "postal_code": "10803",
            "telephone_number": "212-633-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NYFOUNDLING HOSPITAL AKA ST AGATHAS PELHAM MANOR ICF",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2020-08-22",
        "certification_date": "2020-01-30",
        "status": "A",
        "authorized_official_last_name": "BACCAGLINI",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "212-886-4075",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "NY",
            "license": "07107440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00518754",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pelham Manor, 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.