NPIMap

Organization Active NPI

St. Lukes Roosevelt Hospital Center

  • Methadone Clinic
  • New York, NY
National Provider Identifier
1609476357
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
ST. LUKES ROOSEVELT HOSPITAL CENTER
Practice address
1000 10TH Ave
New York, NY 10019-1147
Phone
(212) 256-3296
NPI assigned
Oct 30, 2020
Last updated
Oct 26, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
MOUNT SINAI ST LUKES HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 26, 2022

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

Authorized official

Name
Luka Surameli
Title
Director of Behavioral Health
Phone
(212) 523-5639

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X NU Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU

Addresses

Primary practice location

1000 10TH Ave
New York, NY 10019-1147

Mailing address

160 Water St FL 24
New York, NY 10038-4922
Phone (212) 256-3296

Other names 1

  • OTP Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090506000114 NY Part A Provider - Hospital 1355250788 1 other NPI on this enrollment
Practice locations: New York, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1609476357. Details of each certification follow.

Hospital certification: CCN 330046

Legal name
ST LUKES ROOSEVELT HOSPITAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Aug 30, 2024
Beds
1,028
Ownership / control type
Church
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1936 in NY
Enrollment address
1000 Tenth Avenue
New York, NY 10019-1147
Hospital subgroups
Acute care, Psychiatric unit, Rehabilitation unit

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

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Mount Sinai WestCCN 330046 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Stlukes-Roosevelt Hospital26 organizations share this tax ID, including this one
Part of
Stlukes-Roosevelt Hospital

Other organizations with this tax ID 25

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

View all 25

Ownership & related parties

All disclosed owners & managing parties 25

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

NameRoleSinceShare
Eric Mindich Individual Corporate DirectorDirector Jan 1, 2015
Frank Bisignano Individual Corporate DirectorBoard of Directors Dec 24, 2019
John S Winkleman Individual Corporate DirectorDirector Jan 1, 2015
Susan Cullman Individual Corporate DirectorBoard of Directors Dec 24, 2019
Denis Donegan Individual Corporate OfficerVice President Jan 1, 2022 100%
W-2 Managing EmployeeVice President Jan 1, 2022 100%
Operational/Managerial ControlVice President Jan 1, 2022 100%
John a Levin Individual Corporate DirectorDirector Jan 1, 2015
Robert Savage Individual Corporate DirectorBoard of Directors Dec 24, 2019
Joel S. Ehrenkranz Individual Corporate DirectorBoard of Directors Dec 24, 2019
Richard a Friedman Individual Corporate DirectorBoard of Director Jan 1, 2022
James E Flynn Individual Corporate DirectorBoard of Directors Dec 24, 2019
Thomas W Strauss Individual Corporate Director Jan 1, 2015
Joel Picket Individual Corporate DirectorBoard of Directors Dec 24, 2019
James Neary Individual Corporate DirectorBoard of Directors Dec 24, 2019
William Wright Individual Corporate DirectorBoard of Directors Dec 24, 2019
Henry M Calderon Individual Corporate DirectorBoard of Directors Dec 24, 2019
James S Tisch Individual Corporate DirectorBoard of Directors Dec 24, 2019
John B Hess Individual Corporate DirectorDirector Jan 1, 2015
Steven Hochberg Individual Corporate DirectorDirector Jan 1, 2015
Peter W May Individual Corporate DirectorBoard of Director Jan 1, 2022
Judith O Rubin Individual Corporate Director Jan 1, 2015
Louis Pell Individual Corporate DirectorBoard of Directors Dec 24, 2019
Timothy Day Individual Corporate Director Apr 1, 2009
James Gogel Individual Corporate DirectorDirector Jan 1, 2015
Michael Zimmerman Individual Corporate DirectorBoard of Directors Dec 24, 2019
Michael Minikes Individual Corporate DirectorBoard of Directors Dec 24, 2019

Practitioners & affiliated clinicians

Affiliated clinicians 1,047

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

View all 1,047

NPI Registry JSON

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

{
    "created_epoch": "1604016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666742400000",
    "number": "1609476357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 WATER ST FL 24",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100384922",
            "telephone_number": "212-256-3296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 10TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191147",
            "telephone_number": "212-256-3296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKES ROOSEVELT HOSPITAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOUNT SINAI ST LUKES HOSPITAL",
        "enumeration_date": "2020-10-30",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A",
        "authorized_official_last_name": "SURAMELI",
        "authorized_official_first_name": "LUKA",
        "authorized_official_title_or_position": "DIRECTOR OF BEHAVIORAL HEALTH",
        "authorized_official_telephone_number": "212-523-5639"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OTP",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "OTP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.