NPIMap

Organization Active NPI

Upstate Cerebral Palsy, Inc.

  • Clinic/Center
  • Barneveld, NY
National Provider Identifier
1649624941
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
6282310 Issued in NY
Legal business name
UPSTATE CEREBRAL PALSY, INC.
Practice address
10708 N Gage Rd
Barneveld, NY 13304-2527
Phone
(315) 896-2654
Fax
(315) 896-2717
NPI assigned
Apr 22, 2016
Last updated
Apr 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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
Clinic/Center 261Q00000X 6282310 NY Primary

Addresses

Primary practice location

10708 N Gage Rd
Barneveld, NY 13304-2527

Mailing address

125 Business Park Dr
Utica, NY 13502-6305
Phone (315) 724-6907

Other names 1

  • United Cerebral Palsy, Inc. 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
Margaret D Kordylewska29 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 9

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": "1461283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680652800000",
    "number": "1649624941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 BUSINESS PARK DR",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135026305",
            "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": "10708 N GAGE RD",
            "city": "BARNEVELD",
            "state": "NY",
            "postal_code": "133042527",
            "telephone_number": "315-896-2654",
            "fax_number": "315-896-2717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE CEREBRAL PALSY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-22",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "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": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NY",
            "license": "6282310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "United Cerebral Palsy, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "United Cerebral Palsy, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Barneveld, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; 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.