NPIMap

Organization Active NPI

The James a. Eddy Memorial Geriatric Center, Inc.

  • Skilled Nursing Facility
  • Troy, NY
National Provider Identifier
1609820265
Registry record updated Mar 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
4102309N Issued in NY
Legal business name
THE JAMES A. EDDY MEMORIAL GERIATRIC CENTER, INC.
Practice address
2256 Burdett Ave
Troy, NY 12180-2400
Phone
(518) 274-9890
Fax
(518) 274-5407
NPI assigned
May 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2015

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

Authorized official

Name
Ms. Juanita Wheeler-Moore
Title
Director of Cbo
Phone
(518) 268-4906

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 4102309N NY Primary

Addresses

Primary practice location

2256 Burdett Ave
Troy, NY 12180-2400

Mailing address

55 Mohawk St Ste 102
Cohoes, NY 12047-2600
Phone (518) 274-9890

Other identifiers 6

IdentifierTypeStateIssuer
000400135001OtherNYBLUE SHIELD OF NE NY
7740256OtherNYAETNA
00545208MedicaidNY
10030782OtherNYCDPHP
00872899MedicaidNY
009612OtherNYBLUE CROSS

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040816000172 NY Part A Provider - Skilled Nursing Facility 6002889466 Practice locations: Troy, NY
O20150115001702 NY Part B Supplier - Clinic/Group Practice 6002889466 Receives reassigned benefits from 19 practitioners
Practice locations: Troy, NY

Skilled nursing facility certification: CCN 335680

Legal name
THE JAMES A EDDY MEMORIAL GERIATRIC CENTER, INC
Doing business as
EDDY MEMORIAL GERIATRIC CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 4, 1985
Last certification
Aug 9, 2024
Beds
80
Ownership / control type
Nonprofit Corporation
Multi-facility organization
St. Peters Health Partners
Organization structure
CorporationNon-profit
Incorporated
Aug 8, 1984 in NY
Enrollment address
2256 Burdett Ave
Troy, NY 12180-2501
Nursing home name
EDDY MEMORIAL GERIATRIC CENTER
Affiliated entity
TRINITY HEALTH

Care Compare: Nursing home

Medicare Care Compare
Listed as
Eddy Memorial Geriatric CenterCCN 335680
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Feb 4, 1985
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8076.7 residents per day on average
Chain
Trinity Health19 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0161688Eddy Memorial Geriatric Center2256 Burdett Ave, Troy, NY 12180Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

Locations

55 Mohawk St
Ste 102
Cohoes, NY 12047

2256 Burdett Ave
Troy, NY 12180
Phone (518) 274-9890

Ownership & related parties

All disclosed owners & managing parties 38

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

NameRoleSinceShare
Michael K Burke Individual Operational/Managerial Control Sep 1, 2020
Adp of the SNF Sep 1, 2020
Organization, Troy, NY LLC, Consulting firm, For-profit Adp of the SNF Apr 18, 2025
Melissa M Bakar Individual Adp of the SNF Jan 1, 2025
Merriette Pollard Individual Corporate DirectorBoard Member Oct 1, 2022
Individual Adp of the SNF Jul 1, 2019
Eric Farrell Individual Corporate OfficerSecretary of the Board Jul 1, 2023
Adp of the SNF Jul 1, 2023
Organization, Arlington, TX LLC, Medical staffing company, For-profit Adp of the SNF Apr 18, 2025
St Peters Health Partners Organization, Albany, NY Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Oct 1, 2011 100%
Operational/Managerial Control Oct 1, 2011
Adp of the SNF May 16, 2025
Patricia Lapczynski Individual Corporate DirectorBoard Member Apr 1, 2025
Frank Cachioli Individual Adp of the SNF Jan 19, 2025
John Marshall Individual Corporate OfficerTreasurer of the Board Oct 5, 2022
Alexandra Smith Individual Operational/Managerial Control Nov 10, 2024
Adp of the SNF Nov 10, 2024
Kathleen M Jimino Individual Corporate OfficerChair of the Board Oct 5, 2022
William Wildridge Individual Corporate OfficerVice Chair of the Board Oct 1, 2022
Steven Donald Hanks Individual Corporate DirectorBoard Member Jan 1, 2023
Adp of the SNF Jan 1, 2023
Teresa Armao Individual Adp of the SNF Feb 21, 2021
Michael Meath Individual Corporate DirectorBoard Member Oct 1, 2022
Guha Bala Individual Corporate DirectorBoard Member Oct 1, 2022
Organization, Charlotte, NC Corporation, Medical staffing company, Consulting firm, For-profit Adp of the SNF Apr 18, 2025
Organization, Glenview, IL LLC, Medical staffing company, Consulting firm, For-profit Adp of the SNF Apr 18, 2025
Kristen Lankenau Individual Adp of the SNF Oct 1, 2023
Gina Myers Individual Corporate DirectorBoard Member Oct 1, 2022
Organization, Albany, NY Corporation, Medical staffing company, For-profit Adp of the SNF Apr 18, 2025
Kristin a Signor Individual Corporate OfficerVP of Finance and Operations Apr 1, 2017
Operational/Managerial Control Apr 1, 2017
Adp of the SNF Apr 1, 2017
Organization, Asheville, NC Corporation, Medical staffing company, For-profit Adp of the SNF Apr 18, 2025
Michelle T Mazzacco Individual Operational/Managerial Control Aug 22, 2021
Adp of the SNF Aug 22, 2021
Organization, Pittsford, NY Consulting firm, For-profit Adp of the SNF Apr 18, 2025
Marguerite Sullivan Individual Corporate DirectorBoard Member Jan 1, 2025
Organization, Albany, NY Corporation, Non-profit Adp of the SNF Apr 18, 2025
Organization, Boca Raton, FL Corporation, Medical provider/supplier, For-profit Adp of the SNF Apr 18, 2025
Trinity Health Corporation Organization, Livonia, MI Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Jul 1, 2014 100%
Operational/Managerial Control Jul 1, 2014
Adp of the SNF Apr 18, 2025
Daniel Isacksen Individual Corporate DirectorEx-Officio Board Member Oct 1, 2022
Adp of the SNF Oct 1, 2022
Organization, Overland Park, KS LLC, Medical staffing company, For-profit Adp of the SNF Apr 18, 2025
Kerri Sweet Zavaglia Individual Corporate DirectorBoard Member Oct 1, 2022
Robert J McCormick Individual Corporate DirectorBoard Member Jan 1, 2021
Oluwatoyin Tofade Individual Corporate DirectorBoard Member Jan 1, 2024
Organization, Albany, NY Corporation, Medical staffing company, For-profit Adp of the SNF Apr 18, 2025
Organization, Sarasota, FL Corporation, Consulting firm, For-profit Adp of the SNF Apr 18, 2025

Owners & managing parties with NPI records 3

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

Facilities with the same owner 157

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 157

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 21

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425859200000",
    "number": "1609820265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 MOHAWK ST STE 102",
            "city": "COHOES",
            "state": "NY",
            "postal_code": "120472600",
            "telephone_number": "518-274-9890",
            "fax_number": "518-274-5407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2256 BURDETT AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121802400",
            "telephone_number": "518-274-9890",
            "fax_number": "518-274-5407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE JAMES A. EDDY MEMORIAL GERIATRIC CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2015-03-09",
        "status": "A",
        "authorized_official_last_name": "WHEELER-MOORE",
        "authorized_official_first_name": "JUANITA",
        "authorized_official_title_or_position": "DIRECTOR OF CBO",
        "authorized_official_telephone_number": "518-268-4906",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "4102309N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF NE NY",
            "identifier": "000400135001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7740256",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00545208",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10030782",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00872899",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "009612",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, NY

Sources for this page

Verify at the official NPI Registry.