Active NPI
Loretto Rest Realty Corporation
- Clinic/Center
- Syracuse, NY
National Provider Identifier
1548366271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- License
- 3301209R
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryLocations
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.
-
- Nurse Practitioner
- East Syracuse, NY
- NPI 1023774809
-
- Adult Health Nurse Practitioner
- East Syracuse, NY
- NPI 1568138394
-
- Family Nurse Practitioner
- North Syracuse, NY
- NPI 1285985242
-
- Psychiatric/Mental Health Nurse Practitioner
- East Syracuse, NY
- NPI 1881112837
-
- Family Medicine Physician
- Manlius, NY
- NPI 1134104979
-
- Optometrist
- Fayetteville, NY
- NPI 1417039363
-
- Physician Assistant
- Syracuse, NY
- NPI 1114094380
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.