NPIMap

Organization Active NPI

Samaritan Medical Center

  • General Acute Care Hospital
  • Watertown, NY
National Provider Identifier
1598713745
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
2201000H Issued in NY
Legal business name
SAMARITAN MEDICAL CENTER
Practice address
830 Washington St
Watertown, NY 13601-4034
Phone
(315) 785-4000
Fax
(315) 785-5761
NPI assigned
May 4, 2006
Last updated
Dec 15, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Authorized official

Name
Ms. Chris Hochgraf
Title
Director of Revenue Cycle
Phone
(315) 779-5278

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 2201000H NY Primary

Addresses

Primary practice location

830 Washington St
Watertown, NY 13601-4034

Mailing address

830 Washington St
Watertown, NY 13601-4034
Phone (315) 785-4000

Other identifiers 1

IdentifierTypeStateIssuer
00354316MedicaidNY

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040227000525 NY Part B Supplier - Clinic/Group Practice 8123914876 Receives reassigned benefits from 218 practitioners
2 other NPIs on this enrollment
Practice locations: Cape Vincent, NY; Watertown, NY; Evans Mills, NY; Clayton, NY; Adams, NY
O20101022000246 NY Part A Provider - Hospital 8123914876 Practice locations: Watertown, NY; Evans Mills, NY; Clayton, NY; Cape Vincent, NY; Adams, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1598713745. Details of each certification follow.

Hospital certification: CCN 330157

Legal name
SAMARITAN MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Oct 6, 2023
Beds
287
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Oct 1, 1881 in NY
Enrollment address
830 Washington St
Watertown, NY 13601-4034
Main/Primary Hospital Location
Hospital subgroups
Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Samaritan Medical CenterCCN 330157 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

452 W Grangeville Blvd
Hanford, CA 93230
Phone (559) 410-8446

909 Strawberry Ln
Clayton, NY 13624
Phone (315) 686-2094

26908 Independence Way
Ste 101
Evans Mills, NY 13637
Phone (315) 629-4525

26908 Independence Way
Ste 106
Evans Mills, NY 13637

104 Paddock St
Ste 202
Watertown, NY 13601

19320 US Route 11
Bldg 3
Watertown, NY 13601

629 Washington St
Watertown, NY 13601
Phone (315) 755-3650

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
John Wheeler Individual Corporate DirectorBoard Member Jan 1, 2022
Kimberly Laclair Individual Corporate DirectorBoard Member Jan 1, 2022
Chris Hochgraf Individual W-2 Managing EmployeeDirector of Revenue Cycle Jan 1, 2022
Operational/Managerial ControlDirector of Revenue Cycle Jan 1, 2022
Dierdra D Sorrell Individual Corporate DirectorBoard Member Jan 1, 2022
John Patrick Barrett Individual Corporate DirectorBoard Member Jan 1, 2022
Kevin L Chandler Individual Corporate DirectorBoard Member Jan 1, 2022
Paul Barton Individual Corporate DirectorBoard Member Jan 1, 2022
Maxine a Briggs Individual Corporate DirectorBoard Member Jan 1, 2022
W-2 Managing EmployeeChief Financial Officer Jan 1, 2022
Operational/Managerial ControlChief Financial Officer Jan 1, 2021
Joan Treadwell-Woods Individual Corporate DirectorBoard Member Apr 1, 2010
Mary Wardwell Donahue Individual Corporate DirectorBoard Member Jan 1, 2022
Denise Young Individual Corporate DirectorBoard Member Jan 1, 2022
Marie Hess Individual Corporate DirectorBoard Member Jan 1, 2022
Jan Turcotte Individual Corporate DirectorBoard Member Apr 1, 2010
Timothy Virkler Individual Corporate DirectorBoard Member Jan 1, 2022
Tracy Leonard Individual Corporate DirectorBoard Member Jan 1, 2022
David Paul Rechlin Individual Corporate DirectorBoard Member Apr 1, 2010
Thomas H Carman Individual Corporate DirectorBoard Member Apr 1, 2010
W-2 Managing EmployeeCeo Apr 1, 2010 100%
Stephen Todd Individual Corporate DirectorBoard Member Jan 1, 2022

Owners & managing parties with NPI records 3

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

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 252

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.

View all 252

Affiliated clinicians 536

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

View all 536

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639526400000",
    "number": "1598713745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 WASHINGTON ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136014034",
            "telephone_number": "315-785-4000",
            "fax_number": "315-785-5761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 WASHINGTON ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136014034",
            "telephone_number": "315-785-4000",
            "fax_number": "315-785-5761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMARITAN MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A",
        "authorized_official_last_name": "HOCHGRAF",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "315-779-5278",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NY",
            "license": "2201000H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00354316",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

Verify at the official NPI Registry.