Organization Active NPI

Loretto Rest Realty Corporation

  • Clinic/Center
  • Syracuse, NY
National Provider Identifier
1548366271
Registry record updated Apr 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
3301209R Issued in NY
Legal business name
LORETTO REST REALTY CORPORATION
Practice address
700 E Brighton Ave
Syracuse, NY 13205-2201
Phone
(315) 469-5570
NPI assigned
Sep 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2008

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

Authorized official

Name
Mrs. Kathleen M Collins
Title
Chief Financial Officer
Phone
(315) 413-3277

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 3301209R NY Primary

Addresses

Primary practice location

700 E Brighton Ave
Syracuse, NY 13205-2201

Mailing address

700 E Brighton Ave
Syracuse, NY 13205-2201
Phone (315) 469-5570

Other names 1

  • Loretto Geriatric Center Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040429000502 NY Part B Supplier - Clinic/Group Practice 3678560703 Receives reassigned benefits from 5 practitioners
Practice locations: East Syracuse, NY

National Provider Directory

National Provider Directory

Locations

115 Creek Cir
East Syracuse, NY 13057
Phone (315) 452-5800

Practitioners & affiliated clinicians

Practitioners 41

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

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207612800000",
    "number": "1548366271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E BRIGHTON AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132052201",
            "telephone_number": "315-469-5570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E BRIGHTON AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132052201",
            "telephone_number": "315-469-5570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LORETTO REST REALTY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2008-04-08",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "315-413-3277",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NY",
            "license": "3301209R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Loretto Geriatric Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; 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.