NPIMap

Organization Active NPI

Upstate Cerebral Palsy, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Utica, NY
National Provider Identifier
1578623617
Registry record updated Oct 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
00474180
Legal business name
UPSTATE CEREBRAL PALSY, INC.
Practice address
1020 Mary St
Utica, NY 13501-1930
Phone
(315) 724-6907
Fax
(315) 733-0791
NPI assigned
Dec 11, 2006
Last updated
Oct 26, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2018

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

Authorized official

Name
Geno Decondo
Title
Executive Director
Phone
(315) 724-6907

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 00474180 Primary

Addresses

Primary practice location

1020 Mary St
Utica, NY 13501-1930

Mailing address

1020 Mary St
Utica, NY 13501-1930
Phone (315) 724-6907

Other identifiers 1

IdentifierTypeStateIssuer
00474180MedicaidNY

Other names 1

  • United Cerebral Palsy Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040719001380 NY Part B Supplier - Clinic/Group Practice 5496734758 Receives reassigned benefits from 66 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Utica, NY; Sauquoit, NY; Morrisville, NY; Herkimer, NY; Boonville, NY; Barneveld, NY; Rome, NY

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
Upstate Cerebral Palsy Inc29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

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

View all 28

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540512000000",
    "number": "1578623617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 MARY ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135011930",
            "telephone_number": "315-724-6907",
            "fax_number": "315-733-0791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 MARY ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135011930",
            "telephone_number": "315-724-6907",
            "fax_number": "315-733-0791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE CEREBRAL PALSY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2018-10-26",
        "status": "A",
        "authorized_official_last_name": "DECONDO",
        "authorized_official_first_name": "GENO",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "315-724-6907"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": "00474180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00474180",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "United Cerebral Palsy",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "United Cerebral Palsy",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Utica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2018; 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.