NPIMap

Organization Active NPI

Ellis Hospital

  • Adult Mental Health Clinic/Center
  • Schenectady, NY
National Provider Identifier
1497949622
Registry record updated Mar 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
6525110A Issued in NY
Legal business name
ELLIS HOSPITAL
Practice address
1023 State St
Schenectady, NY 12307-1511
Phone
(518) 243-3300
Fax
(518) 377-9151
NPI assigned
Aug 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2018

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

Authorized official

Name
Paul A Milton
Title
Ceo
Phone
(518) 243-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X 6525110A NY Primary

Addresses

Primary practice location

1023 State St
Schenectady, NY 12307-1511

Mailing address

1023 State St
Schenectady, NY 12307-1511
Phone (518) 243-3300

Other identifiers 1

IdentifierTypeStateIssuer
01207038MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Edward W Doucet MD37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

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

View all 36

Locations

1023 State St
Schenectady, NY 12307
Phone (518) 243-3300

NPI Registry JSON

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

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520899200000",
    "number": "1497949622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1023 STATE ST",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123071511",
            "telephone_number": "518-243-3300",
            "fax_number": "518-377-9151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 STATE ST",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123071511",
            "telephone_number": "518-243-3300",
            "fax_number": "518-377-9151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIS HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-30",
        "last_updated": "2018-03-13",
        "status": "A",
        "authorized_official_last_name": "MILTON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "518-243-4000"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NY",
            "license": "6525110A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01207038",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Schenectady, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2018; 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.