Sun River Health Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

SUN RIVER HEALTH INC

Practice address

888 Pulaski Hwy
Hudson River Healthcare, Inc.
Goshen, NY 10924-6034

Phone

(845) 651-2298

Fax

(845) 651-2299

NPI assigned

Dec 19, 2006

Last updated

Mar 11, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

SUN RIVER HEALTH INCAs reported in NPPES

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

Authorized official

Name

Adam Lipton

Title

VP Info/Practice MGMT Systems

Phone

(914) 384-2375

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1598828386. Details of each certification follow.

• CCN 331871 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 331871

Legal name

SUN RIVER HEALTH INC.

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Oct 1, 1991

Last certification

Oct 1, 1991

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Aug 5, 1975 in NY

Enrollment address

888 Pulaski Hwy
Goshen, NY 10924-6034

Other NPIs on the same Medicare enrollment 1

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

• Sun River Health Inc.

  • Federally Qualified Health Center (FQHC)
  • Peekskill, NY
  • NPI 1619969458

  O20070822000079

  Same enrollment

Part of

Michael J Gallina

Locations

All disclosed owners & managing parties 17

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

Practitioners 6

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.

• Dominic Cappelleri, MD

  • Internal Medicine Physician
  • Goshen, NY
  • NPI 1912985227
  NPD (past)
• Kenney Gould, LMSW

  • Clinical Social Worker
  • Goshen, NY
  • NPI 1073997557
  NPD (past)
• Regina A. Gruber, M.D.

  • Pediatrics Physician
  • Goshen, NY
  • NPI 1861414831
  NPD (past)
• Jyothi S. Kavuri, D.D.S

  • Dentist
  • Goshen, NY
  • NPI 1548271836
  NPD (past)
• Zulma Rosado, M.D.

  • Family Medicine Physician
  • Goshen, NY
  • NPI 1639181639
  NPD (past)
• Raul Horacio Zambrano, MD

  • Family Medicine Physician
  • Dayton, OH
  • NPI 1598736472
  NPD (past)

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646956800000",
    "number": "1598828386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5036",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106025036",
            "telephone_number": "914-734-8800",
            "fax_number": "914-734-8786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 PULASKI HWY",
            "address_2": "HUDSON RIVER HEALTHCARE, INC.",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109246034",
            "telephone_number": "845-651-2298",
            "fax_number": "845-651-2299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN RIVER HEALTH INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUN RIVER HEALTH INC",
        "enumeration_date": "2006-12-19",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A",
        "authorized_official_last_name": "LIPTON",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "VP INFO/PRACTICE MGMT SYSTEMS",
        "authorized_official_telephone_number": "914-384-2375"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00473038",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna Kathryn Streeter
• Stress Reduction and Psychological Services, PC (Center for Stress Reduction)
• Striving to Restore, Psychotherapy Services LCSW, PLLC
• Sugar Loaf Mental Wellness and Consulting, LLC
• John Michael Sullivan
• Allison Sutherland, CRPA-P
• Mary Hennessey Sutherland, LCSW
• Lisa A Sweeney, OTR/L
• Chelesa Taylor, LCSW
• Elias Taylor

• Federally Qualified Health Center (FQHC) in Goshen, NY
• Providers in Goshen, NY by specialty
• Federally Qualified Health Center (FQHC) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.