NPIMap

Organization Active NPI

United Memorial Medical Center

  • Hematology & Oncology Physician
  • Batavia, NY
National Provider Identifier
1508260704
Registry record updated Oct 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
UNITED MEMORIAL MEDICAL CENTER
Practice address
127 North St
Second Floor
Batavia, NY 14020-1631
Phone
(585) 344-5252
Fax
(585) 344-7497
NPI assigned
Oct 17, 2014
Last updated
Oct 17, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2014

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

Authorized official

Name
Robert Chiavetta
Title
Cfo/Authorized Official
Phone
(585) 344-5439

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X Primary

Addresses

Primary practice location

127 North St
Second Floor
Batavia, NY 14020-1631

Mailing address

908 Niagara Falls Blvd
Suite 208
North Tonawanda, NY 14120-2019
Phone (716) 692-2160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040507000847 NY Part B Supplier - Clinic/Group Practice 0547259376 Receives reassigned benefits from 888 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Manhasset, NY; West Point, NY; Syracuse, NY; Perry, NY; New York, NY; Medina, NY; Le Roy, NY; Jericho, NY…
O20101227000369 NY Part A Provider - Hospital 0547259376 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Corfu, NY; Medina, NY; Le Roy, NY; Bergen, NY; Batavia, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1508260704. Details of each certification follow.

Hospital certification: CCN 330073

Legal name
UNITED MEMORIAL MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Mar 7, 2024
Beds
166
Ownership / control type
Private (not for profit)
Organization structure
OtherNon-profit
Incorporated
Jan 1, 2000 in NY
Enrollment address
16 Bank St
Batavia, NY 14020-2250
Other Hospital Practice Location
Hospital subgroups
Acute care

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
United Memorial Medical CenterCCN 330073 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

127 North St
Fl Second
Batavia, NY 14020
Phone (585) 344-5252

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Marcie Salerno Individual W-2 Managing Employee Apr 26, 2021
James Sunser Individual Corporate DirectorBoard Vice-Chair Jul 1, 2019
Nichole S Holder Individual W-2 Managing EmployeePayor Enrollment Director Jul 1, 2020
Richard O Davis Individual Corporate OfficerCeo Mar 1, 2022
Peter Zeliff Individual Corporate DirectorBoard Member Jul 1, 2019
Peter Thomas Janes Individual Corporate OfficerBoard Member Jan 1, 2019
Tracy Ford Individual Corporate Director Sep 1, 2023
Betty Lapp Individual Corporate DirectorBoard Member Jul 1, 2011
Howard Glastonbury Individual Corporate OfficerVice-President/Cfo Corp. Finance Jul 1, 2019
Richard Henry Individual Corporate Director Sep 1, 2023
Thomas E Houseknecht Individual Corporate DirectorBoard Member Jul 1, 2011
Augusta Welsh Individual Corporate DirectorBoard Member Jul 1, 2011
Joseph Miles Individual W-2 Managing Employee Sep 1, 2023
Mark C Schoell Individual Corporate DirectorBoard Chair Sep 27, 2004
Susie Ott Individual Corporate DirectorBoard Member Jul 1, 2019
Daniel Ireland Individual Corporate DirectorPresident Jan 1, 2019 100%
Thomas R Crilly Individual Corporate DirectorExec. VP/Cfo Jan 1, 2019

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

Affiliated clinicians 389

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 389

NPI Registry JSON

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

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413504000000",
    "number": "1508260704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 NIAGARA FALLS BLVD",
            "address_2": "SUITE 208",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141202019",
            "telephone_number": "716-692-2160",
            "fax_number": "716-213-0935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 NORTH ST",
            "address_2": "SECOND FLOOR",
            "city": "BATAVIA",
            "state": "NY",
            "postal_code": "140201631",
            "telephone_number": "585-344-5252",
            "fax_number": "585-344-7497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED MEMORIAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-17",
        "last_updated": "2014-10-17",
        "status": "A",
        "authorized_official_last_name": "CHIAVETTA",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CFO/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "585-344-5439"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Batavia, NY

Sources for this page

Verify at the official NPI Registry.