NPIMap

Organization Active NPI

Phelps Memorial Hospital Association

  • Psychiatric Hospital
  • Sleepy Hollow, NY
National Provider Identifier
1497917918
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
PHELPS MEMORIAL HOSPITAL ASSOCIATION
Practice address
701 N Broadway
Sleepy Hollow, NY 10591-1020
Phone
(914) 366-3000
Fax
(914) 366-1017
NPI assigned
Jun 26, 2008
Last updated
Jul 31, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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

Authorized official

Name
Mrs. Michele Lee Cusack
Title
Senior Vice President & Cfo
Phone
(516) 321-6058

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X NU Primary

Addresses

Primary practice location

701 N Broadway
Sleepy Hollow, NY 10591-1020

Mailing address

972 Brush Hollow Rd FL 5
Westbury, NY 11590-1740
Phone (516) 876-6065

Other identifiers 1

IdentifierTypeStateIssuer
00274162MedicaidNY

Other names 1

  • Phelps Hospital Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://172.254.9.13:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081015000614 NY Part A Provider - Hospital 1658283981 Practice locations: Sleepy Hollow, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1497917918. Details of each certification follow.

Hospital certification: CCN 33S261

Legal name
PHELPS MEMORIAL HOSPITAL ASSOCIATION
Doing business as
PSYCHIATRIC SUB PROVIDER HOSPITAL UNIT
Organization structure
CorporationNon-profit
Incorporated
Nov 4, 1954 in NY
Enrollment address
701 N Broadway
Sleepy Hollow, NY 10591-1020
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Phelps Mem Hosp15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 53

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
William L Mack Individual Corporate Director Jan 1, 1997
Margaret M Crotty Individual Corporate Director Jan 1, 2019
Benjamin Tucker Individual Corporate Director Jan 1, 2022
Gary Cohen Individual Corporate Director Jan 1, 2021
Michael Caridi Individual Corporate Director Jan 1, 2019
Northwell, Inc. Organization, Westbury, NY Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Jul 1, 2024 100%
Lois C Schlissel Individual Corporate Director Jan 1, 2024
Emmett Walker Individual Corporate Director Jan 1, 2020
Michael E Feldman Individual Corporate Director Jan 1, 1983
Catherine C Foster Individual Corporate Director Jan 1, 2010
Harry E Gindi Individual Corporate Officer Jan 1, 2025
Lloyd M Goldman Individual Corporate Director Jan 1, 1994
Cary Kravet Individual Corporate Director Jan 1, 2022
Jeffrey a Kraut Individual Corporate Officer Jan 1, 2025
Gregory W Rakow Individual Corporate Director Jan 1, 2025
Robert D Rosenthal Individual Corporate Director Jan 1, 1994
Robert R Dyson Individual Corporate Director Jan 1, 2025
Mark L Claster Individual Corporate Director Jan 1, 1997
Brian Lally Individual Corporate Officer Jan 1, 2025
Michael Fisch Individual Corporate Director Jan 1, 2018
Jeffrey Lane Individual Corporate Director Jan 1, 1987
Mark J Solazzo Individual Corporate Officer Jan 1, 2025
Richard D Goldstein Individual Corporate Director Jan 1, 1995
Northwell Healthcare Inc Organization, Westbury, NY Corporation, Non-profit, Chain home office 5% Or Greater Direct Ownership Interest Jan 1, 2015 100%
Operational/Managerial Control Jan 1, 2015 100%
David L Battinelli Individual Corporate Officer Jan 1, 2025
Anne Roby Individual Corporate Director Jan 1, 2025
Mark Gudis Individual Corporate Director Jan 1, 2025
Alan I Greene Individual Corporate Director Jan 1, 1973
Donald Zucker Individual Corporate Director Jan 1, 1987
Barry Rubenstein Individual Corporate Director Jan 1, 1990
Laurie Lederman Individual Corporate Director Jan 1, 2024
Northwell Health Inc Organization, Westbury, NY Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Jan 1, 2015 100%
Saul Katz Individual Corporate Director Jan 1, 1990
Scott Rechler Individual Corporate Director Jan 1, 2020
Roy Zuckerberg Individual Corporate Director Jan 1, 1981
Michael a Epstein Individual Corporate Director Jan 1, 2005
Steven V Lant Individual Corporate Director Jan 1, 2026
Mark a. Gloade Individual Corporate Officer Jan 1, 2025
John K D'Angelo Individual Corporate Officer Jan 1, 2025
Donna K Drummond Individual Corporate Officer Jan 1, 2025
Richard Mack Individual Corporate Director Jan 1, 2020
Michael J Dowling Individual Corporate Director Jan 1, 2001
Donald Jones Individual Corporate Director Jan 1, 2025
Laurence a Kraemer Individual Corporate Officer Jan 1, 2025
Konstantine Costalas Individual Corporate Officer Jan 1, 2025
Lewis Ranieri Individual Corporate Director Jan 1, 2002
Paul Guenther Individual Corporate Director Jan 1, 2010
Kenneth Taber Individual Corporate Director Jan 1, 2017
Roger a Blumencranz Individual Corporate Director Jan 1, 1994
Ralph a Nappi Individual Corporate Director Jan 1, 1971
Michael Smith Individual Corporate Director Jan 1, 2020
Douglas Hammond Individual Corporate Director Jan 1, 2021
Michele L Cusack Individual Corporate OfficerExecutive Vice President & Cfo Sep 12, 2017
W-2 Managing EmployeeSenior Vice President & Cfo Sep 12, 2017

Owners & managing parties with NPI records 3

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

Facilities with the same owner 42

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 42

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753920000000",
    "number": "1497917918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "972 BRUSH HOLLOW RD FL 5",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115901740",
            "telephone_number": "516-876-6065",
            "fax_number": "516-876-5572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N BROADWAY",
            "city": "SLEEPY HOLLOW",
            "state": "NY",
            "postal_code": "105911020",
            "telephone_number": "914-366-3000",
            "fax_number": "914-366-1017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHELPS MEMORIAL HOSPITAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-26",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A",
        "authorized_official_last_name": "CUSACK",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT & CFO",
        "authorized_official_telephone_number": "516-321-6058",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00274162",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://172.254.9.13:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.1",
            "affiliationName": "Bluemark",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "40 Sunset Ridge Rd",
            "city": "New Paltz",
            "state": "NY",
            "country_code": "US",
            "postal_code": "125611036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Phelps Hospital",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sleepy Hollow, NY

Sources for this page

Verify at the official NPI Registry.