NPIMap

Organization Active NPI

Northern Oswego County Health Services, Inc.

  • Community Health Clinic/Center
  • Pulaski, NY
National Provider Identifier
1508850280
Registry record updated Feb 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
License
3726201R Issued in NY
Legal business name
NORTHERN OSWEGO COUNTY HEALTH SERVICES, INC.
Practice address
61 Delano St
Pulaski, NY 13142-1400
Phone
(315) 298-6569
Fax
(315) 298-7488
NPI assigned
Sep 8, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2026

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

Authorized official

Name
Alisha Crisp
Title
Credentialing Specialist
Phone
(315) 298-6564

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X 3726201R NY Primary

Addresses

Primary practice location

61 Delano St
Pulaski, NY 13142-1400

Mailing address

61 Delano St
Pulaski, NY 13142-1400
Phone (315) 298-6569

Other identifiers 1

IdentifierTypeStateIssuer
00307662MedicaidNY

Other names 1

  • ConnextCare Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY6 enrollments

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
O20031106000070 NY Part B Supplier - Clinic/Group Practice 8426961541 Receives reassigned benefits from 88 practitioners
Practice locations: Pulaski, NY; Phoenix, NY; Parish, NY; Oswego, NY; Mexico, NY; Fulton, NY; Central Square, NY
O20090928000302 NY Part A Provider - Federally Qualified Health Center (FQHC) 8426961541 Practice locations: Pulaski, NY
O20160105000605 NY Part A Provider - Federally Qualified Health Center (FQHC) 8426961541 Practice locations: Fulton, NY
O20210727001744 NY Part A Provider - Federally Qualified Health Center (FQHC) 8426961541 1 other NPI on this enrollment
Practice locations: Central Square, NY
O20220106002485 NY Part A Provider - Federally Qualified Health Center (FQHC) 8426961541 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mexico, NY
O20240725003131 NY Part A Provider - Federally Qualified Health Center (FQHC) 8426961541 Practice locations: Oswego, NY

Federally qualified health center certification: CCN 331880

Legal name
NORTHERN OSWEGO COUNTY HEALTH SERVICES, INC.
Doing business as
CONNEXTCARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 1, 1994
Last certification
Aug 1, 1994
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
61 Delano St
Pulaski, NY 13142-1400

Federally qualified health center certification: CCN 331198

Legal name
NORTHERN OSWEGO COUNTY HEALTH SERVICES, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 15, 2016
Last certification
Apr 15, 2016
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 24, 1969 in NY
Enrollment address
716 Academy St
Fulton, NY 13069-1912

Federally qualified health center certification: CCN 571831

Legal name
NORTHERN OSWEGO COUNTY HEALTH SERVICES, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 11, 2022
Last certification
May 11, 2022
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 1, 1969 in NY
Enrollment address
3045 RT 49
Central Square, NY 13036-2611

Federally qualified health center certification: CCN 571821

Legal name
NORTHERN OSWEGO COUNTY HEALTH SERVICES, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 22, 2021
Last certification
Dec 22, 2021
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 1, 1969 in NY
Enrollment address
26 Academy St
Mexico, NY 13114-3010

Federally qualified health center certification: CCN 571864

Legal name
NORTHERN OSWEGO COUNTY HEALTH SERVICES, INC.
Doing business as
CONNEXTCARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 25, 2024
Last certification
Jul 25, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 24, 1969 in NY
Enrollment address
1 Buccaneer Blvd
Oswego, NY 13126-1953

All disclosed owners & managing parties 26

Medicare enrollment files

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

NameRoleSinceShare
Tracy Wimmer Individual Corporate Officer Jul 1, 2017
W-2 Managing EmployeeVP/Chief Financial Officer Jul 1, 2017
Corporate OfficerVP/Cfo Jun 1, 2021
Corporate OfficerChief Financial Officer / Vice Pres Jun 1, 2021
Kathleen Berardi Individual Corporate OfficerBoard Member Apr 1, 2025
David Dingman Individual Corporate OfficerBoard Member Jan 1, 2019
Corporate Director May 1, 2019
Corporate DirectorVice Chair Aug 21, 2019
Steven Gaffney Individual Corporate DirectorChairperson Sep 17, 2009
Corporate Director Apr 1, 1998
Corporate Director May 1, 1998
Corporate Officer May 1, 1998
Corporate DirectorBoard Chair Jan 1, 2023
Tricia Peter Clark Individual Corporate OfficerVP/Chief Operating Officer Jan 1, 2013
Corporate DirectorVP/Chief Operating Officer Jan 1, 2013
W-2 Managing EmployeeVP/Chief Operating Officer Jan 1, 2013
Corporate OfficerPresident/Ceo Jun 4, 2021 100%
W-2 Managing EmployeePresident/Ceo Mar 7, 2016
Corporate OfficerPresiden Ceo Jun 4, 2021 100%
W-2 Managing Employee Mar 7, 2016 5%
Corporate OfficerChief Executive Officer Jun 4, 2021 100%
W-2 Managing EmployeeAd;President Ceo Mar 7, 2016 5%
Robert Trainham Individual Corporate OfficerBoard Member Apr 1, 2007
Corporate OfficerTreasurer Jan 2, 2005
Corporate Director May 1, 2005
Timothy McCluskey Individual Corporate OfficerBoard Member Apr 1, 2007
Corporate OfficerPresident Apr 1, 2007
Corporate Director May 1, 1999
Corporate Officer May 1, 1999
Felicity Hallanan Individual Corporate OfficerBoard Member Jun 1, 2010
Corporate Director Jun 1, 2007
Corporate Director May 1, 2010
Jessica Hoyt Individual Corporate OfficerBoard Member Apr 1, 2025
Kristin Labarge Individual Corporate OfficerBoard Member Apr 1, 2024
Corporate Director Apr 1, 2024
Kathleen McLeod Individual Corporate OfficerBoard Member Jan 1, 2007
Corporate Director Jan 2, 2007
Corporate Director May 1, 2007
James Oldenburg Individual Corporate OfficerBoard Member Jan 1, 2018
Corporate Director May 1, 2018
Tammie Nipper Individual Corporate OfficerBoard Member Apr 1, 2023
Corporate Director Apr 1, 2024
Micheal D Stephens Individual Corporate OfficerBoard Member Apr 1, 2020
Corporate Director May 1, 2020
Corporate Director Apr 1, 2020
Robert Oustrich Individual Corporate OfficerBoard Member Jan 1, 2017
Corporate Director May 1, 2017
Lauren Seiter Individual Corporate OfficerBoard Member Jan 1, 2016
Corporate Director May 1, 2016
Rose Ann Jerrett Individual Corporate OfficerBoard Member Jan 1, 2003
Corporate OfficerVice President Aug 3, 2003
Corporate Director May 1, 2003
Karen Paterniti Individual Corporate OfficerChief Financial Officer Jun 29, 2007
Corporate Director Jun 29, 2007
W-2 Managing Employee Jun 29, 2007
Michael Backus Individual Corporate Director Jan 2, 2009
Corporate Officer May 1, 2009
Corporate DirectorBoard Chair May 1, 2019 100%
Daniel Dey Individual Corporate Officer Dec 3, 2007
Corporate Director Dec 3, 2007
W-2 Managing EmployeeChief Executive Officer Dec 3, 2007
Contracted Managing Employee Sep 17, 2009
Corporate Officer Sep 17, 2009
Traci Mintonye Individual Corporate Officer Mar 1, 2008
Judith Catella Individual Corporate Director Apr 1, 1988
Corporate Director May 1, 1988
Patricia Hill Kohr Individual Corporate OfficerSecretary Apr 1, 2008
Melissa Dragicevich Individual Corporate Director Jan 2, 2005
Stan Long Individual Corporate Director Jan 2, 2007
Susan Lobdell Individual Corporate Director May 1, 2018

All facility ownership & control disclosures 8

Medicare enrollment files

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Northern Oswego County Health Services, Inc.Phoenix, NY, CCN 331135 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2013
Northern Oswego County Health Services, Inc.Parish, NY, CCN 331133 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2013
Northern Oswego County Health Services, Inc.Mexico, NY, CCN 331132 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2013
Northern Oswego County Health Services, Inc.Parish, NY, CCN 331139 Federally qualified health center Operational/Managerial Control (100%) Oct 1, 2012
Northern Oswego County Health Services, Inc.Parish, NY, CCN 331140 Federally qualified health center Operational/Managerial Control (100%) Jan 20, 2008
Northern Oswego County Health Services, Inc.Mexico, NY, CCN 331142 Federally qualified health center Operational/Managerial Control (100%) Jan 24, 2014
Northern Oswego County Health Services, Inc.Pulaski, NY, CCN 331141 Federally qualified health center Operational/Managerial Control (100%) Feb 28, 2004
Northern Oswego County Health Services, Inc.Pulaski, NY, CCN 331144 Federally qualified health center Operational/Managerial Control (100%) Feb 28, 2004

National Provider Directory

National Provider Directory

Locations

510 S 4th St
Ste 600
Fulton, NY 13069
Phone (315) 598-4790

10 George St
#200
Oswego, NY 13126
Phone (315) 342-0880

10 George St
Ste 200
Oswego, NY 13126
Phone (315) 342-0880

120 E 1st St
Oswego, NY 13126
Phone (315) 342-0880

1 Buccaneer Blvd
Oswego, NY 13126
Phone (315) 341-2600

640 County Route 22
Parish, NY 13131
Phone (315) 625-5210

Owners & managing parties with NPI records 1

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

Owned or controlled facilities with NPI records 8

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs on the same Medicare enrollment 2

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

Other NPIs with the same Medicare PAC ID 12

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

Practitioners 88

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 88

NPI Registry JSON

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769990400000",
    "number": "1508850280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 DELANO ST",
            "city": "PULASKI",
            "state": "NY",
            "postal_code": "131421400",
            "telephone_number": "315-298-6569",
            "fax_number": "315-298-7488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 DELANO ST",
            "city": "PULASKI",
            "state": "NY",
            "postal_code": "131421400",
            "telephone_number": "315-298-6569",
            "fax_number": "315-298-7488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN OSWEGO COUNTY HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-08",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A",
        "authorized_official_last_name": "CRISP",
        "authorized_official_first_name": "ALISHA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "315-298-6564"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NY",
            "license": "3726201R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00307662",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ConnextCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pulaski, NY

Sources for this page

Verify at the official NPI Registry.