NPIMap

Organization Active NPI

County of Chemung

Doing business as Chemung County Department of Health Home Health Agency

  • Home Health Agency
  • Elmira, NY
National Provider Identifier
1528054194
Registry record updated Jan 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
0701901L Issued in NY
Legal business name
COUNTY OF CHEMUNG
Doing business as
Chemung County Department of Health Home Health Agency
Practice address
103 Washington St
Elmira, NY 14902-0588
Phone
(607) 737-2001
Fax
(607) 737-2016
NPI assigned
Sep 20, 2005
Last updated
Jan 22, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
COUNTY OF CHEMUNGAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 22, 2018

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

Authorized official

Name
Mr. Peter Buzzetti III, MPH
Title
Public Health Director
Phone
(607) 737-2868

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 0701600 NY
Home Health Agency 251E00000X 0701901L NY Primary

Addresses

Primary practice location

103 Washington St
Elmira, NY 14902-0588

Mailing address

103 Washington St
Elmira, NY 14902-0588
Phone (607) 737-2001

Other identifiers 3

IdentifierTypeStateIssuer
00372743MedicaidNY
00671081MedicaidNY
00719773MedicaidNY

Other names 1

  • Chemung County Department of Health Home Health Agency Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100521000701 NY Part A Provider - Home Health Agency 4688692874 Practice locations: Elmira, NY
O20170302000950 NY Part B Supplier - Clinic/Group Practice 4688692874 Receives reassigned benefits from 9 practitioners
1 other NPI on this enrollment
Practice locations: Elmira, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1528054194. Details of each certification follow.

Home health agency certification: CCN 337003

Legal name
COUNTY OF CHEMUNG
Doing business as
CHEMUNG COUNTY DEPARTMENT OF HEALTH HOME HEALTH AGENCY
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 1, 1966
Last certification
Jul 26, 2019
Ownership / control type
Government Operated
Organization structure
GovernmentNon-profit
Enrollment address
103 Washington St
Elmira, NY 14901-3220

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Chemung Co Dept Health ChhaCCN 337003 · All quality measures
Overall star rating
4 of 5
Ownership
Government Operated
Certified
Jul 1, 1966
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0666129Chemung County Nursing Facility103 Washington Street, Elmira, NY 14902Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory
Tax ID family
Chemung Cty NF5 organizations share this tax ID, including this one
Part of
Chemung Cty NF

Other organizations with this tax ID 4

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

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Shelly L Russell Individual W-2 Managing EmployeeSenior Account Clerk Dec 16, 2019 40%
County of Chemung Organization, Elmira, NY 5% Or Greater Direct Ownership Interest Jan 1, 1987 100%
Michelle Lynn Beard Individual W-2 Managing EmployeeSupervisor of Fiscal Services Jul 17, 2023 30%
Christina Standt Individual W-2 Managing EmployeeDirector of Patient Services Nov 15, 2022 70%
Operational/Managerial ControlDirector of Patient Services Nov 15, 2022 70%
Peter Buzzetti Individual W-2 Managing EmployeeDirector of Public Health Jan 1, 2018 100%
Operational/Managerial ControlDirector of Public Health Jan 1, 2018 100%

Owners & managing parties with NPI records 1

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

  • County of Chemung

    dba Chemung County Nursing Facility

    • Skilled Nursing Facility
    • Elmira, NY
    • NPI 1629063573

    5% Or Greater Direct Ownership Interest

    CMS ownership

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Chemung County Nursing FacilityElmira, NY, CCN 335480 Skilled nursing facility Operational/Managerial Control (100%) Nov 6, 2008

Owned or controlled facilities with NPI records 1

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

  • County of Chemung

    dba Chemung County Nursing Facility

    • Skilled Nursing Facility
    • Elmira, NY
    • NPI 1629063573

    Operational/Managerial Control

    CMS ownership

Facilities with the same owner 1

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

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 9

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.

Affiliated clinicians 11

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

NPI Registry JSON

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516579200000",
    "number": "1528054194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 WASHINGTON ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149020588",
            "telephone_number": "607-737-2001",
            "fax_number": "607-737-2016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 WASHINGTON ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149020588",
            "telephone_number": "607-737-2001",
            "fax_number": "607-737-2016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF CHEMUNG",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF CHEMUNG",
        "enumeration_date": "2005-09-20",
        "last_updated": "2018-01-22",
        "status": "A",
        "authorized_official_last_name": "BUZZETTI",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "PUBLIC HEALTH DIRECTOR",
        "authorized_official_telephone_number": "607-737-2868",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MPH"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": "0701600",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": "0701901L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00372743",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00671081",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00719773",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chemung County Department of Health Home Health Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elmira, NY

Sources for this page

Verify at the official NPI Registry.