NPIMap

Organization Active NPI

State of New York

  • Specialist
  • West Haverstraw, NY
National Provider Identifier
1508987348
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
STATE OF NEW YORK
Practice address
51- 55 North Route 9W
West Haverstraw, NY 10993-1195
Phone
(845) 786-4202
Fax
(845) 947-0036
NPI assigned
Apr 2, 2007
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
Ms. Magdalena Ramirez
Title
Ceo
Phone
(845) 786-4202

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

51- 55 North Route 9W
West Haverstraw, NY 10993-1195

Mailing address

51-55 North Route 9W
West Haverstraw, NY 10993-1195
Phone (845) 786-4202

Other names 1

  • Helen Hayes Hospital Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040313000077 NY Part B Supplier - Clinic/Group Practice 0840101770 Receives reassigned benefits from 65 practitioners
36 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Stony Brook, NY; West Haverstraw, NY

Other NPIs on the same Medicare enrollment 36

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

View all 36

National Provider Directory

National Provider Directory

Locations

51 N Route 9W
#55
West Haverstraw, NY 10993
Phone (845) 786-4202

Practitioners & affiliated clinicians

Practitioners 51

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

View all 51

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508987348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51-55 NORTH ROUTE 9W",
            "city": "WEST HAVERSTRAW",
            "state": "NY",
            "postal_code": "109931195",
            "telephone_number": "845-786-4202",
            "fax_number": "845-947-0036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51- 55 NORTH ROUTE 9W",
            "city": "WEST HAVERSTRAW",
            "state": "NY",
            "postal_code": "109931195",
            "telephone_number": "845-786-4202",
            "fax_number": "845-947-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF NEW YORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RAMIREZ",
        "authorized_official_first_name": "MAGDALENA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "845-786-4202",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Helen Hayes Hospital",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in West Haverstraw, 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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.