Upstate Cerebral Palsy, Inc.
Organization Active NPI Clinic/Center · Barneveld, NY
NPI 1649624941 · NPPES record last updated Apr 5, 2023
Key facts
- NPI
- 1649624941
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- License
- 6282310 (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
- Organization subpart
- No
Authorized official
- Name
- Geno Decondo
- Title
- Executive Director
- Phone
- (315) 724-6907
Other NPIs on the same Medicare enrollment 3
Corporate family (same tax ID) 28
Practitioners 9
-
Sara Nicole Bessette, M.S, LMHC
-
Alexa R Donaruma, LCSW
-
Stephen Hudyncia, M.D.
-
Laura Ja Miller, LCSW/CASAC
-
Veronica Verenich-Makayed, PT, DPT
-
Esma Zagorica, LMSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- Upstate Cerebral Palsy Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | 6282310 | NY | Yes |
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
- United Cerebral Palsy, Inc.
Other providers in Barneveld, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.